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General NPI Number Information
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NPI Number | 1669958229
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Entity Type | Individual
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Provider Name | DULCE ELENA PEDRAZA
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Gender | Female
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 620 PAREDES LINE RD STE E
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3694
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Country | US
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Telephone | 956-621-0277
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Fax | 956-621-0427
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Provider Business Mailing Address
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Address Line | 620 PAREDES LINE RD STE E
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3694
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Country | US
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Telephone | 956-621-0277
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Fax | 956-621-0427
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 212863
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License Number State | TX
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