Provider Demographics
NPI:1417560004
Name:CARRIZALES, MARGARITA CARMEN
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:CARMEN
Last Name:CARRIZALES
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 1:8503 CHELSEA PARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2552
Mailing Address - Country:US
Mailing Address - Phone:210-275-4077
Mailing Address - Fax:
Practice Address - Street 1:8503 CHELSEA PARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2552
Practice Address - Country:US
Practice Address - Phone:210-275-4077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer