Provider Demographics
NPI:1477954964
Name:SENIZAIZ, REBECCA CLAIRE (MPT)
Entity Type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:CLAIRE
Last Name:SENIZAIZ
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:CLAIRE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:218 CHAMPION DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4640
Mailing Address - Country:US
Mailing Address - Phone:469-484-6812
Mailing Address - Fax:469-519-1612
Practice Address - Street 1:218 CHAMPION DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4640
Practice Address - Country:US
Practice Address - Phone:469-484-6812
Practice Address - Fax:469-519-1612
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41642225100000X
TX1283069225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1477954964OtherNPI