Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2071576 | TX |
NPI | 1003446030 |
---|---|
Provider Name | Graciela Rangel |
First Address | Laredo, TX 78041-6040 |
Second Address | Laredo, TX 78041-6040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2020 |
Last Update Date | 17/01/2020 |