Provider Demographics
NPI:1568085538
Name:BARRACO, CHRISTINA DANIELLE (RCS, RVS)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DANIELLE
Last Name:BARRACO
Suffix:
Gender:F
Credentials:RCS, RVS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5723 GLENMERE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-7845
Mailing Address - Country:US
Mailing Address - Phone:214-415-3471
Mailing Address - Fax:
Practice Address - Street 1:5723 GLENMERE LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7845
Practice Address - Country:US
Practice Address - Phone:214-415-3471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-25
Last Update Date:2020-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
000734312471S1302X, 2471V0105X, 246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography