MEDICARE: RACHEL JEAN TREMAINE PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	2102705	TX

General Provider Information

NPI Number	:	1477297968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL JEAN TREMAINE PTA

Provider Business Mailing Address
First Line	:	1406 E HOUSTON ST
Second Line	:
City	:	BEEVILLE
State	:	TX
Zip	:	78102-5346
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1406 E HOUSTON ST
Second Line	:
City	:	BEEVILLE
State	:	TX
Zip	:	78102-5346
Country	:	US
Telephone Number	:	361-542-4652
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2022
Last Update Date	:	04/21/2022

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Directions to “ RACHEL JEAN TREMAINE PTA” Practice Location

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