Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2083243 | TX |
NPI | 1013289461 |
---|---|
Provider Name | Fatoumata Badio |
First Address | Harlingen, TX 78550-8847 |
Second Address | Harlingen, TX 78550-8847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2012 |
Last Update Date | 01/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
21738201 | (05) | TX |