Provider Demographics
NPI:1407688021
Name:CISNEROS RATHMELL, ALEXIS CRISTINE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:CRISTINE
Last Name:CISNEROS RATHMELL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:CRISTINE
Other - Last Name:CISNEROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2116 GALVESTON ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-2911
Mailing Address - Country:US
Mailing Address - Phone:956-771-9880
Mailing Address - Fax:
Practice Address - Street 1:5702 MCPHERSON RD STE 15
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6884
Practice Address - Country:US
Practice Address - Phone:956-725-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1387914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist