Provider Demographics
NPI:1992769673
Name:STEVENS, TONYA K (PT)
Entity type:Individual
Prefix:MISS
First Name:TONYA
Middle Name:K
Last Name:STEVENS
Suffix:
Gender:F
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:PO BOX 496
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:75855-0496
Mailing Address - Country:US
Mailing Address - Phone:210-215-3912
Mailing Address - Fax:
Practice Address - Street 1:1340 WONDER WORLD DR
Practice Address - Street 2:BLDG. 2, SUITE 2100
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7598
Practice Address - Country:US
Practice Address - Phone:512-753-3539
Practice Address - Fax:512-753-3541
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1161639225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX808447Medicare ID - Type Unspecified