Provider Demographics
NPI:1780825729
Name:REDUBLO, ALDUAINE JOSE (PT,CWS,NCS)
Entity Type:Individual
Prefix:MR
First Name:ALDUAINE
Middle Name:JOSE
Last Name:REDUBLO
Suffix:
Gender:M
Credentials:PT,CWS,NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7329 NEW BRUNSWICK DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3233
Mailing Address - Country:US
Mailing Address - Phone:361-991-5145
Mailing Address - Fax:361-991-5145
Practice Address - Street 1:7329 NEW BRUNSWICK DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3233
Practice Address - Country:US
Practice Address - Phone:361-991-5145
Practice Address - Fax:361-991-5145
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-22
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1104354225100000X
TX124252251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology