Provider Demographics
NPI:1306387527
Name:SERRA, CHONA DIGNOS
Entity Type:Individual
Prefix:MRS
First Name:CHONA
Middle Name:DIGNOS
Last Name:SERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14807 WOODLAND HILLS DR APT 7107
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4664
Mailing Address - Country:US
Mailing Address - Phone:832-267-0626
Mailing Address - Fax:
Practice Address - Street 1:14807 WOODLAND HILLS DR APT 7107
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4664
Practice Address - Country:US
Practice Address - Phone:832-267-0626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1253193225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist