Provider Demographics
NPI:1336304047
Name:MINEKER, STEVEN PAUL (MPT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:PAUL
Last Name:MINEKER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 532127
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8268
Mailing Address - Country:US
Mailing Address - Phone:956-428-8951
Mailing Address - Fax:956-428-0232
Practice Address - Street 1:1801 N ED CAREY DR
Practice Address - Street 2:SUITE C
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8268
Practice Address - Country:US
Practice Address - Phone:956-428-8951
Practice Address - Fax:956-428-0232
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155133225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX219090201Medicaid
TX8L12804Medicare PIN