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NPI Code Detail

MEDICARE: MRS. CARINA MICHELLE NASRALLAH ATC

MEDICARE:  MRS. CARINA MICHELLE NASRALLAH  ATC
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
12255A2300XAthletic Trainer0126002452VA
22255A2300XAthletic TrainerAT7268TX

General Provider Information

NPI Number : 1124477302
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARINA MICHELLE NASRALLAH ATC
Provider Business Mailing Address
First Line : 6445 MAIN ST STE 2500
Second Line :
City : HOUSTON
State : TX
Zip : 77030-1502
Country : US
Telephone Number : 713-824-4454
Fax Number :
Provider Business Practice Location Address
First Line : 6445 MAIN ST STE 2500
Second Line :
City : HOUSTON
State : TX
Zip : 77030-1502
Country : US
Telephone Number : 713-824-4454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2016
Last Update Date : 12/27/2017

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Directions to “ MRS. CARINA MICHELLE NASRALLAH ATC” Practice Location

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