Provider Demographics
NPI:1871930511
Name:BURGOS, REY MARTIN CAPARAS (PT)
Entity type:Individual
Prefix:MR
First Name:REY MARTIN
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 1:7510 COUNSELOR WAY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3200
Mailing Address - Country:US
Mailing Address - Phone:682-219-2600
Mailing Address - Fax:
Practice Address - Street 1:7510 COUNSELOR WAY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-3200
Practice Address - Country:US
Practice Address - Phone:682-219-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1230691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1230691OtherTEXAS BOARD OF PHYSICAL THERAPY EXAMINERS