Provider Demographics
NPI:1710032883
Name:STACY-STEINER, REBECCA ANN (MS, LPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:STACY-STEINER
Suffix:
Gender:F
Credentials:MS, LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 828
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8144
Mailing Address - Country:US
Mailing Address - Phone:972-562-0190
Mailing Address - Fax:
Practice Address - Street 1:1416 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1806
Practice Address - Country:US
Practice Address - Phone:972-562-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11576562251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178573501Medicaid