Provider Demographics
NPI:1033790639
Name:MATHERNE, RIA ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:RIA
Middle Name:ANN
Last Name:MATHERNE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:RIA
Other - Middle Name:
Other - Last Name:LEDET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:581 PAN AMERICAN DR STE 3
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-1960
Mailing Address - Country:US
Mailing Address - Phone:254-394-2710
Mailing Address - Fax:254-307-9700
Practice Address - Street 1:581 PAN AMERICAN DR STE 3
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1960
Practice Address - Country:US
Practice Address - Phone:254-394-2710
Practice Address - Fax:254-307-9700
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10916225100000X
TX1390121225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist