Provider Demographics
NPI:1467842138
Name:ESCOBEDO, REBBECCA JO (ATC)
Entity Type:Individual
Prefix:
First Name:REBBECCA
Middle Name:JO
Last Name:ESCOBEDO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7326 S STAPLES ST STE A
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5509
Mailing Address - Country:US
Mailing Address - Phone:956-867-7611
Mailing Address - Fax:
Practice Address - Street 1:7326 S STAPLES ST STE A
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-5509
Practice Address - Country:US
Practice Address - Phone:956-867-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20000159912255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer