Provider Demographics
NPI:1164710943
Name:RAUMA, JOSEPH GERARD (PTA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:GERARD
Last Name:RAUMA
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 ROSA LN
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1911
Mailing Address - Country:US
Mailing Address - Phone:832-445-4934
Mailing Address - Fax:
Practice Address - Street 1:221 ROSA LN
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1911
Practice Address - Country:US
Practice Address - Phone:832-445-4934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20082982251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology