Provider Demographics
NPI:1861428187
Name:MINGUEZ, MAJAL BUENAFLOR (PT)
Entity type:Individual
Prefix:MRS
First Name:MAJAL
Middle Name:BUENAFLOR
Last Name:MINGUEZ
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 1:774 ROBINSON LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:75949-3229
Mailing Address - Country:US
Mailing Address - Phone:936-422-4295
Mailing Address - Fax:936-634-4285
Practice Address - Street 1:609 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3820
Practice Address - Country:US
Practice Address - Phone:936-634-4282
Practice Address - Fax:936-634-4285
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1121374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1948Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER