Provider Demographics
NPI:1124411434
Name:GADBERY, REBECCA (PT, DPT ATC)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GADBERY
Suffix:
Gender:F
Credentials:PT, DPT ATC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:GAULT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 N COLLEGIATE DR
Mailing Address - Street 2:SUITE 550
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-1494
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 N COLLEGIATE DR
Practice Address - Street 2:SUITE 550
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-1494
Practice Address - Country:US
Practice Address - Phone:903-784-3173
Practice Address - Fax:903-784-7912
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1255249225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist