Provider Demographics
NPI:1730537242
Name:ROJAS, GINOVON ESPARZA (DPT)
Entity type:Individual
Prefix:
First Name:GINOVON
Middle Name:ESPARZA
Last Name:ROJAS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:GINO
Other - Middle Name:ESPARZA
Other - Last Name:ROJAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78291-0087
Mailing Address - Country:US
Mailing Address - Phone:210-358-9172
Mailing Address - Fax:210-358-9183
Practice Address - Street 1:701 S ZARZAMORA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-5209
Practice Address - Country:US
Practice Address - Phone:210-358-7024
Practice Address - Fax:210-358-7869
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1246829225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist