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General NPI Number Information
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NPI Number | 1366944324
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Entity Type | Individual
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Provider Name | PATRICIA BERNAL-CARREON PTA
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Gender | Female
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Dates
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Enumeration Date | 03/06/2018
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 16002 WRANGLER RUN CT
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City | CYPRESS
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State | TX
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Zip | 77429
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Country | US
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Telephone | 713-824-8457
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Fax | 281-256-8641
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Provider Business Mailing Address
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Address Line | 16002 WRANGLER RUN CT
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City | CYPRESS
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State | TX
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Zip | 77429-5260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2060720
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License Number State | TX
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