Provider Demographics
NPI:1982827416
Name:HUERTA, ROBERTO RENE (PT)
Entity Type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:RENE
Last Name:HUERTA
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 1:5123 S MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-8278
Mailing Address - Country:US
Mailing Address - Phone:956-664-0900
Mailing Address - Fax:956-664-0904
Practice Address - Street 1:5123 S MCCOLL RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8278
Practice Address - Country:US
Practice Address - Phone:956-664-0900
Practice Address - Fax:956-664-0904
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1146017225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist