Provider Demographics
NPI:1780806521
Name:TRUJILLO, REBECCA A (PTA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:
Other - Last Name:TRUJILLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PTA
Mailing Address - Street 1:3130 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-6139
Mailing Address - Country:US
Mailing Address - Phone:956-664-1816
Mailing Address - Fax:956-687-5638
Practice Address - Street 1:3130 N 23RD ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6139
Practice Address - Country:US
Practice Address - Phone:956-664-1816
Practice Address - Fax:956-687-5638
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2012811225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant