Provider Demographics
NPI:1144215328
Name:BERKSTRESSER, PATRICIA LUCILLE (PT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LUCILLE
Last Name:BERKSTRESSER
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 1:11923 MEADOWDALE DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-1712
Mailing Address - Country:US
Mailing Address - Phone:281-495-6557
Mailing Address - Fax:281-495-0517
Practice Address - Street 1:11923 MEADOWDALE DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-1712
Practice Address - Country:US
Practice Address - Phone:281-495-6557
Practice Address - Fax:281-495-0517
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist