Healthcare Provider Details

I. General information

NPI: 1386509925
Provider Name (Legal Business Name): SHAIRENA BROCATO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KALENNE BROCATO

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 CAPPS ST
MARLIN TX
76661-2306
US

IV. Provider business mailing address

322 CAPPS ST
MARLIN TX
76661-2306
US

V. Phone/Fax

Practice location:
  • Phone: 940-337-2311
  • Fax:
Mailing address:
  • Phone: 940-337-2311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number20252242P
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: