Provider Demographics
NPI:1265471460
Name:BROCHU, JULIE (PT, MSPT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:BROCHU
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 N NOLAN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-7925
Mailing Address - Country:US
Mailing Address - Phone:817-641-8617
Mailing Address - Fax:817-641-8620
Practice Address - Street 1:1014 N NOLAN RIVER RD
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-7925
Practice Address - Country:US
Practice Address - Phone:817-641-8617
Practice Address - Fax:817-641-8620
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1125771225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP24618Medicare UPIN
TX83452EMedicare PIN