Provider Demographics
NPI:1871476531
Name:ESTRADA, RONALD ALLAN BALLELOS (PT)
Entity type:Individual
Prefix:MR
First Name:RONALD ALLAN
Middle Name:BALLELOS
Last Name:ESTRADA
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 1:2100 CENTER DR APT 604
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-4841
Mailing Address - Country:US
Mailing Address - Phone:940-886-6540
Mailing Address - Fax:
Practice Address - Street 1:725 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-4524
Practice Address - Country:US
Practice Address - Phone:325-672-3236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPT1200089261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy