Provider Demographics
NPI:1669133914
Name:NUNEZ, STEPHANIE CRYSTAL (PTA)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CRYSTAL
Last Name:NUNEZ
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 1:14355 LOMA ESMERALDA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-1237
Mailing Address - Country:US
Mailing Address - Phone:915-256-7776
Mailing Address - Fax:
Practice Address - Street 1:2114 N ZARAGOZA RD STE C1
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-8129
Practice Address - Country:US
Practice Address - Phone:915-271-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2114461225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant