Provider Demographics
NPI:1386112068
Name:BURGOS, REY JULIUS CAPARAS (PT)
Entity type:Individual
Prefix:MR
First Name:REY JULIUS
Middle Name:CAPARAS
Last Name:BURGOS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 SLAYDEN ST APT 130
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5539
Mailing Address - Country:US
Mailing Address - Phone:325-203-0272
Mailing Address - Fax:
Practice Address - Street 1:118 S PARK DR
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5957
Practice Address - Country:US
Practice Address - Phone:325-203-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-11
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1276892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist