Provider Demographics
NPI:1366570608
Name:ISLAS, FELIX (DPT)
Entity type:Individual
Prefix:
First Name:FELIX
Middle Name:
Last Name:ISLAS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HOSPITAL LOOP
Mailing Address - Street 2:
Mailing Address - City:FAIRCHILD AFB
Mailing Address - State:WA
Mailing Address - Zip Code:99011-8704
Mailing Address - Country:US
Mailing Address - Phone:509-247-3279
Mailing Address - Fax:
Practice Address - Street 1:201 MITCHELL BLVD BLDG 375
Practice Address - Street 2:
Practice Address - City:LAUGHLIN AFB
Practice Address - State:TX
Practice Address - Zip Code:78843-5212
Practice Address - Country:US
Practice Address - Phone:830-298-6332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1173613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist