Provider Demographics
NPI:1033690649
Name:GO, BEATRIZ JANINE ECARMA
Entity Type:Individual
Prefix:
First Name:BEATRIZ JANINE
Middle Name:ECARMA
Last Name:GO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 TEAL LN
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-0178
Mailing Address - Country:US
Mailing Address - Phone:956-777-8284
Mailing Address - Fax:
Practice Address - Street 1:2011 TEAL LN
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-0178
Practice Address - Country:US
Practice Address - Phone:956-777-8284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1292351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist