Provider Demographics
NPI:1336860188
Name:FERGUSON, ALBINA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALBINA
Middle Name:
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 CASTLE ROCK DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2267
Mailing Address - Country:US
Mailing Address - Phone:512-740-6955
Mailing Address - Fax:
Practice Address - Street 1:3701 CASTLE ROCK DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2267
Practice Address - Country:US
Practice Address - Phone:512-740-6955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1364143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist