Provider Demographics
NPI:1134122252
Name:FRANCISCO, MYREL CAMITOC (PT)
Entity Type:Individual
Prefix:MS
First Name:MYREL
Middle Name:CAMITOC
Last Name:FRANCISCO
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 1:210 W PARK
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-8336
Mailing Address - Country:US
Mailing Address - Phone:936-327-8080
Mailing Address - Fax:936-327-8086
Practice Address - Street 1:210 W PARK
Practice Address - Street 2:SUITE 101
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8336
Practice Address - Country:US
Practice Address - Phone:936-327-8080
Practice Address - Fax:936-327-8086
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1149843225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T0935OtherBCBS PAR PLAN PROVIDER #
TX8T0935OtherBCBX BLUE LINK PROVIDER #
TX8T0935OtherBCBX BLUE LINK PROVIDER #