Provider Demographics
NPI:1043529118
Name:CABRERA, ELENDA (PT)
Entity Type:Individual
Prefix:
First Name:ELENDA
Middle Name:
Last Name:CABRERA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 BELL ST
Mailing Address - Street 2:STE D
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8290
Mailing Address - Country:US
Mailing Address - Phone:956-440-0629
Mailing Address - Fax:956-246-4444
Practice Address - Street 1:1901 BELL ST
Practice Address - Street 2:STE D
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8290
Practice Address - Country:US
Practice Address - Phone:956-440-0629
Practice Address - Fax:956-246-4444
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172890225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist