Provider Demographics
NPI:1881816858
Name:DELA CRUZ, RODANTE GUCE (PT)
Entity Type:Individual
Prefix:MR
First Name:RODANTE
Middle Name:GUCE
Last Name:DELA CRUZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W. PARKER ROAD
Mailing Address - Street 2:#906
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076
Mailing Address - Country:US
Mailing Address - Phone:832-876-0934
Mailing Address - Fax:
Practice Address - Street 1:7407 NORTH FREEWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076
Practice Address - Country:US
Practice Address - Phone:832-200-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1156300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist