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General NPI Number Information
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NPI Number | 1366056491
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Entity Type | Individual
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Provider Name | JOSEPH RENTERIA PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/05/2020
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 1700 E PALM VALLEY BLVD STE 395
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City | ROUND ROCK
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State | TX
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Zip | 78664-4683
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Country | US
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Telephone | 512-399-9059
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Fax |
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Provider Business Mailing Address
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Address Line | 148 MORNING DAWN LN
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City | GEORGETOWN
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State | TX
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Zip | 78628-3733
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Country | US
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Telephone | 480-703-8231
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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 |
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License Number State |
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