Provider Demographics
NPI:1710222138
Name:RABOSA, GERALDINE ABEAR (PT)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:ABEAR
Last Name:RABOSA
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 1:2881 CARRERA CT
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-2291
Mailing Address - Country:US
Mailing Address - Phone:832-403-0909
Mailing Address - Fax:281-316-1673
Practice Address - Street 1:2881 CARRERA CT
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2291
Practice Address - Country:US
Practice Address - Phone:832-403-0909
Practice Address - Fax:281-316-1673
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1075208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist