Provider Demographics
NPI:1578953733
Name:BARRAZA, MARK (OCCUPATIONAL THREAPY)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:BARRAZA
Suffix:
Gender:M
Credentials:OCCUPATIONAL THREAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7806 GATEWAY BLVD E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-1800
Mailing Address - Country:US
Mailing Address - Phone:915-566-7584
Mailing Address - Fax:915-566-7682
Practice Address - Street 1:7806 GATEWAY BLVD E
Practice Address - Street 2:SUITE 100
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-1800
Practice Address - Country:US
Practice Address - Phone:915-566-7584
Practice Address - Fax:915-566-7682
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist