Healthcare Provider Details

I. General information

NPI: 1952687147
Provider Name (Legal Business Name): KERRI LYNN FALK PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 W SESAME DR
HARLINGEN TX
78550-7930
US

IV. Provider business mailing address

2814 TREASURE HILLS BLVD APT B
HARLINGEN TX
78550-8680
US

V. Phone/Fax

Practice location:
  • Phone: 956-399-4500
  • Fax:
Mailing address:
  • Phone: 605-868-9476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2094043
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: