Provider Demographics
NPI:1619459328
Name:BARRIENTOS, GRISELDA ADRIANA (PTA)
Entity Type:Individual
Prefix:
First Name:GRISELDA
Middle Name:ADRIANA
Last Name:BARRIENTOS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16422 LAPIS RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3782
Mailing Address - Country:US
Mailing Address - Phone:254-833-0673
Mailing Address - Fax:
Practice Address - Street 1:16422 LAPIS RIVER DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3782
Practice Address - Country:US
Practice Address - Phone:254-833-0673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2137348225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant