Provider Demographics
NPI:1700685963
Name:DEANGELIS, RENAE M (PT)
Entity type:Individual
Prefix:
First Name:RENAE
Middle Name:M
Last Name:DEANGELIS
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 1:310 ABERDEEN
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-5187
Mailing Address - Country:US
Mailing Address - Phone:361-779-7625
Mailing Address - Fax:
Practice Address - Street 1:814 ARION PKWY STE 434
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2837
Practice Address - Country:US
Practice Address - Phone:210-499-0063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12623852251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology