Provider Demographics
NPI:1316753445
Name:ROCKWELL, CYNTHIA L (PTA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:ROCKWELL
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 1:8504 ABILENE CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-3408
Mailing Address - Country:US
Mailing Address - Phone:512-636-3612
Mailing Address - Fax:
Practice Address - Street 1:2500 BARTON CREEK BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-1603
Practice Address - Country:US
Practice Address - Phone:866-607-5995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2176212225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant