Provider Demographics
NPI:1669444998
Name:GANYO, RHONDA M (PT)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:M
Last Name:GANYO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12888 N. PUFFIN LN
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77318
Mailing Address - Country:US
Mailing Address - Phone:936-228-2180
Mailing Address - Fax:936-228-2180
Practice Address - Street 1:4015 I 45 N
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-4901
Practice Address - Country:US
Practice Address - Phone:936-522-4731
Practice Address - Fax:936-522-4736
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1037836225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B7807Medicare ID - Type Unspecified