MEDICARE: DR. REBECCA RAMON PT, DPT

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	225100000X	Physical Therapist	2305212666	VA
2	225100000X	Physical Therapist	9695	SC
3	225100000X	Physical Therapist	1310450	TX
4	225100000X	Physical Therapist	24041	MA

General Provider Information

NPI Number	:	1578043964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECCA RAMON PT, DPT

Provider Business Mailing Address
First Line	:	6830 GATERIDGE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-7932
Country	:	US
Telephone Number	:	972-816-9210
Fax Number	:

Provider Business Practice Location Address
First Line	:	6830 GATERIDGE DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-7932
Country	:	US
Telephone Number	:	972-816-9210
Fax Number	:

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

Provider Enumeration Date	:	08/15/2018
Last Update Date	:	10/13/2021

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