Provider Demographics
NPI:1376853044
Name:GREENWOOD, REBECCA A (PT, DPT, OCS, ATC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:PT, DPT, OCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18707 KELLY MEADOWS LN
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-1528
Mailing Address - Country:US
Mailing Address - Phone:619-384-8846
Mailing Address - Fax:
Practice Address - Street 1:18707 KELLY MEADOWS LN
Practice Address - Street 2:
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-1528
Practice Address - Country:US
Practice Address - Phone:619-384-8846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10992225100000X
TX1244516225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist