Provider Demographics
NPI:1356834451
Name:GAETA, RICHARD J (DPT)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:GAETA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:61 BROAD REACH UNIT M34B
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02191-2278
Mailing Address - Country:US
Mailing Address - Phone:214-551-1566
Mailing Address - Fax:
Practice Address - Street 1:3030 WATERVIEW PKWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1400
Practice Address - Country:US
Practice Address - Phone:972-669-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic