Provider Demographics
NPI:1336273895
Name:CAIN, RICKY ASHTON (LPT)
Entity type:Individual
Prefix:MR
First Name:RICKY
Middle Name:ASHTON
Last Name:CAIN
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3005 S LAMAR BLVD
Mailing Address - Street 2:STE D-112
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-8864
Mailing Address - Country:US
Mailing Address - Phone:512-441-1240
Mailing Address - Fax:512-441-3762
Practice Address - Street 1:3005 S LAMAR BLVD
Practice Address - Street 2:STE D-112
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-8864
Practice Address - Country:US
Practice Address - Phone:512-441-1240
Practice Address - Fax:512-441-3762
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1144574225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist