Provider Demographics
NPI:1407222698
Name:RUSCITTO, ANTONIO II (DPT)
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:
Last Name:RUSCITTO
Suffix:II
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5348 WESTMINSTER DR APT 1334
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-4046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7401 TX-71
Practice Address - Street 2:#130
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78725
Practice Address - Country:US
Practice Address - Phone:512-288-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-21531225100000X
TX1298080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist