Provider Demographics
NPI:1346491206
Name:RAQUEL, CHRISTINE C (PT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:C
Last Name:RAQUEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:CARGANILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:704 BROOKWATER DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5582
Mailing Address - Country:US
Mailing Address - Phone:214-315-6979
Mailing Address - Fax:972-369-1588
Practice Address - Street 1:704 BROOKWATER DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5582
Practice Address - Country:US
Practice Address - Phone:214-315-6979
Practice Address - Fax:972-369-1588
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1118008172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker