Provider Demographics
NPI:1740761493
Name:ANAYA, ALICIA RONEA (PTA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:RONEA
Last Name:ANAYA
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 1:1129 REDWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-5943
Mailing Address - Country:US
Mailing Address - Phone:361-727-5522
Mailing Address - Fax:
Practice Address - Street 1:201 SWIFT ST
Practice Address - Street 2:
Practice Address - City:REFUGIO
Practice Address - State:TX
Practice Address - Zip Code:78377-2428
Practice Address - Country:US
Practice Address - Phone:361-526-4641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2116738225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant