Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1097954 | TX |
NPI | 1003105297 |
---|---|
Provider Name | Cathy Faye Ruelas |
First Address | Lewisville, TX 75067-3921 |
Second Address | Lewisville, TX 75067-3921 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2011 |
Last Update Date | 29/03/2011 |