Provider Demographics
NPI:1568826618
Name:PEREZ-GALLARDO, CRISTINA (OTR)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:PEREZ-GALLARDO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5006 E EXPRESSWAY 83
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-5008
Mailing Address - Country:US
Mailing Address - Phone:956-565-9300
Mailing Address - Fax:956-565-9686
Practice Address - Street 1:5006 E EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-5008
Practice Address - Country:US
Practice Address - Phone:956-565-9300
Practice Address - Fax:956-565-9686
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117563225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist