Provider Demographics
NPI:1528596137
Name:STEWART-RICHLEN, TREVOR (PT, DPT, MS)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:
Last Name:STEWART-RICHLEN
Suffix:
Gender:M
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W 38TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1130
Mailing Address - Country:US
Mailing Address - Phone:325-388-9400
Mailing Address - Fax:
Practice Address - Street 1:900 W 38TH ST STE 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1130
Practice Address - Country:US
Practice Address - Phone:325-388-8246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12877262251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic