Provider Demographics
NPI:1326623406
Name:BRINKLEY, CAREY (LMT)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:
Last Name:BRINKLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CAREY
Other - Middle Name:
Other - Last Name:GAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1503 BRIDAL PATH CV
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6815
Mailing Address - Country:US
Mailing Address - Phone:512-983-9943
Mailing Address - Fax:
Practice Address - Street 1:1503 BRIDAL PATH CV
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-6815
Practice Address - Country:US
Practice Address - Phone:512-983-9943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT104366225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty