Provider Demographics
NPI:1003105297
Name:RUELAS, CATHY FAYE (PT)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:FAYE
Last Name:RUELAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N VALLEY PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3921
Mailing Address - Country:US
Mailing Address - Phone:972-353-5437
Mailing Address - Fax:
Practice Address - Street 1:401 N VALLEY PKWY
Practice Address - Street 2:STE 300
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3921
Practice Address - Country:US
Practice Address - Phone:972-353-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist