Provider Demographics
NPI:1235829870
Name:NYUL, REBECCA (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NYUL
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14057 SAN CHRISTOVAL PASS
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-5824
Mailing Address - Country:US
Mailing Address - Phone:972-679-4875
Mailing Address - Fax:
Practice Address - Street 1:14057 SAN CHRISTOVAL PASS
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-5824
Practice Address - Country:US
Practice Address - Phone:972-679-4875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
TXAT92292255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer