Marisa Rodriguez, PTA

Individual provider Active NPI Physical Therapy Assistant · Friona, TX

NPI 1164071452 · NPPES record last updated Sep 9, 2019

Key facts

NPI
1164071452
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
2060208 (TX)
Practice address
201 E 15TH St
Friona, TX 79035-1207
Phone
(806) 759-5177
NPI assigned
Sep 9, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2060208TXMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2060208 TX Yes

Addresses

Primary practice location

201 E 15TH St
Friona, TX 79035-1207

Mailing address

402 Long St
Hereford, TX 79045-3228
Phone (806) 759-5177

Other providers in Friona, TX

All providers in Friona, TX · Physical Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.