Provider Demographics
NPI:1619431996
Name:RABAEY, ANTHONY (MAT LAT ATC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:RABAEY
Suffix:
Gender:M
Credentials:MAT LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 FM 973
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-4524
Mailing Address - Country:US
Mailing Address - Phone:512-636-2974
Mailing Address - Fax:
Practice Address - Street 1:355 FM 973
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:TX
Practice Address - Zip Code:76574-4524
Practice Address - Country:US
Practice Address - Phone:512-636-2974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-30
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXAT85822255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program