Provider Demographics
NPI:1639492192
Name:BAROMA, MARIA DEL CARMEN BACULO (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIA DEL CARMEN
Middle Name:BACULO
Last Name:BAROMA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 GIORGIO PASTEL PL
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-4131
Mailing Address - Country:US
Mailing Address - Phone:360-791-4318
Mailing Address - Fax:
Practice Address - Street 1:3580 GIORGIO PASTEL PL
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-4131
Practice Address - Country:US
Practice Address - Phone:360-791-4318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60129128225100000X
TX1333576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist