Provider Demographics
NPI:1134458458
Name:CARRERA, MERY CRUZ (OTR, CHT)
Entity Type:Individual
Prefix:MRS
First Name:MERY
Middle Name:CRUZ
Last Name:CARRERA
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7678 S BOARDWALK
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:TX
Mailing Address - Zip Code:77657-6909
Mailing Address - Country:US
Mailing Address - Phone:409-790-1106
Mailing Address - Fax:
Practice Address - Street 1:4650 COLLIER ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7078
Practice Address - Country:US
Practice Address - Phone:409-898-1882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107222225X00000X
1011100545225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand