Provider Demographics
NPI:1508081076
Name:PARISH, CARISSA POOL (PT)
Entity Type:Individual
Prefix:MS
First Name:CARISSA
Middle Name:POOL
Last Name:PARISH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CARISSA
Other - Middle Name:POOL
Other - Last Name:PARISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7909 FREDERICKSBURG RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3400
Mailing Address - Country:US
Mailing Address - Phone:210-614-4544
Mailing Address - Fax:210-679-3724
Practice Address - Street 1:18915 MEISNER DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4223
Practice Address - Country:US
Practice Address - Phone:210-499-5158
Practice Address - Fax:210-679-3730
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1167933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist