Provider Demographics
NPI:1376874834
Name:ADZUARA, RUTH (PT)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:ADZUARA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17448 HIGHWAY 3
Mailing Address - Street 2:SUITE 130
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4141
Mailing Address - Country:US
Mailing Address - Phone:281-316-7160
Mailing Address - Fax:281-316-7165
Practice Address - Street 1:17448 HIGHWAY 3
Practice Address - Street 2:SUITE 130
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4197
Practice Address - Country:US
Practice Address - Phone:281-316-7160
Practice Address - Fax:281-316-7165
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-22
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1034015225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist