Provider Demographics
NPI:1336459874
Name:AUTEA, FERDINAND (PT)
Entity Type:Individual
Prefix:
First Name:FERDINAND
Middle Name:
Last Name:AUTEA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 TESORO ST
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-7580
Mailing Address - Country:US
Mailing Address - Phone:956-283-9442
Mailing Address - Fax:956-283-9456
Practice Address - Street 1:1904 TESORO ST
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-7580
Practice Address - Country:US
Practice Address - Phone:956-283-9442
Practice Address - Fax:956-283-9456
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1192130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist