Provider Demographics
NPI:1932411824
Name:REXWINKLE, ANGELA DIANE (MS)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:DIANE
Last Name:REXWINKLE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 N RIVERSIDE DR # 5650
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-2464
Mailing Address - Country:US
Mailing Address - Phone:210-569-5101
Mailing Address - Fax:
Practice Address - Street 1:5650 N RIVERSIDE DR # 5650
Practice Address - Street 2:SUITE 150
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-2464
Practice Address - Country:US
Practice Address - Phone:210-569-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist