Provider Demographics
NPI:1457004269
Name:BERRIESFORD, ROXANNE MARIE (RCP, RRT)
Entity Type:Individual
Prefix:
First Name:ROXANNE
Middle Name:MARIE
Last Name:BERRIESFORD
Suffix:
Gender:F
Credentials:RCP, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2919 PARKWOOD MANOR DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1203
Mailing Address - Country:US
Mailing Address - Phone:281-602-9353
Mailing Address - Fax:
Practice Address - Street 1:33300 EGYPT LN STE I
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-2739
Practice Address - Country:US
Practice Address - Phone:832-295-4823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRCP00076978227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
159409OtherNBRC CREDENTIALS