Provider Demographics
NPI:1851728372
Name:HURST, REBECCA A (PT)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:A
Last Name:HURST
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 1:1135 N EARL RUDDER FWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77803-5156
Mailing Address - Country:US
Mailing Address - Phone:979-704-3079
Mailing Address - Fax:888-511-7141
Practice Address - Street 1:1135 N EARL RUDDER FWY STE 101
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803-5156
Practice Address - Country:US
Practice Address - Phone:979-704-3079
Practice Address - Fax:888-511-7141
Is Sole Proprietor?:No
Enumeration Date:2013-09-29
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1226224225100000X
TX1114312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist