Healthcare Provider Details

I. General information

NPI: 1912223611
Provider Name (Legal Business Name): ROWENA REYES OLORES PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROWENA BERNARDO REYES PT

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 FRANKFORD RD
DALLAS TX
75252-6834
US

IV. Provider business mailing address

4507 RISINGHILL DR
PLANO TX
75024-7338
US

V. Phone/Fax

Practice location:
  • Phone: 972-232-8096
  • Fax:
Mailing address:
  • Phone: 972-377-7448
  • Fax: 972-232-8099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1073815
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: