Provider Demographics
NPI:1891953881
Name:RAESNER, RITA KAY (PTA)
Entity Type:Individual
Prefix:MRS
First Name:RITA
Middle Name:KAY
Last Name:RAESNER
Suffix:
Gender:F
Credentials:PTA
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 424
Mailing Address - Street 2:
Mailing Address - City:INDUSTRY
Mailing Address - State:TX
Mailing Address - Zip Code:78944-0424
Mailing Address - Country:US
Mailing Address - Phone:979-357-2985
Mailing Address - Fax:
Practice Address - Street 1:111 S CREEK DR
Practice Address - Street 2:
Practice Address - City:BELLVILLE
Practice Address - State:TX
Practice Address - Zip Code:77418-3067
Practice Address - Country:US
Practice Address - Phone:979-865-0434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2032340225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant