Provider Demographics
NPI:1609368620
Name:MARQUEZ, STEPHEN RYNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:RYNE
Last Name:MARQUEZ
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 OAK CENTRE DR STE 450
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4072
Mailing Address - Country:US
Mailing Address - Phone:210-297-4525
Mailing Address - Fax:
Practice Address - Street 1:525 OAK CENTRE DR STE 450
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4072
Practice Address - Country:US
Practice Address - Phone:210-297-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1295545225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist