Provider Demographics
NPI:1932493442
Name:VINYARD, RACHEL ELIZABETH (PT, DPT, MPT, OCS)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ELIZABETH
Last Name:VINYARD
Suffix:
Gender:F
Credentials:PT, DPT, MPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 W PIONEER PKWY STE 108
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-6091
Mailing Address - Country:US
Mailing Address - Phone:682-276-3040
Mailing Address - Fax:817-207-4184
Practice Address - Street 1:2400 W PIONEER PKWY STE 108
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-6091
Practice Address - Country:US
Practice Address - Phone:682-276-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204907225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1204907OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINER