MEDICARE: CRISTINA BASALDU OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0019X	Physical Rehabilitation Occupational Therapist	123242	TX

General Provider Information

NPI Number	:	1003680067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA BASALDU OTR

Provider Business Mailing Address
First Line	:	4330 SPRING CREEK DR.
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78410-5684
Country	:	US
Telephone Number	:	361-728-9138
Fax Number	:

Provider Business Practice Location Address
First Line	:	4330 SPRING CREEK DR.
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78410-5684
Country	:	US
Telephone Number	:	361-728-9138
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2023
Last Update Date	:	11/10/2023

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Directions to “ CRISTINA BASALDU OTR” Practice Location

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