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General NPI Number Information
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NPI Number | 1265764534
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Entity Type | Individual
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Provider Name | JESUS C REGALA III PT
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Gender | Male
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Dates
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Enumeration Date | 02/11/2010
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1250 RIVERSIDE DR
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City | WILMINGTON
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State | DE
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Zip | 19809-2435
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Country | US
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Telephone | 832-788-5769
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Fax |
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Provider Business Mailing Address
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Address Line | 14515 WUNDERLICH DR APT 819
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City | HOUSTON
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State | TX
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Zip | 77069-2833
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Country | US
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Telephone | 832-788-5769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | J1-0002484
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT019993
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 021895
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305205380
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1144111
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License Number State | TX
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