Provider Demographics
NPI:1659325884
Name:BOOKER, CHARA MARIE (DPT)
Entity Type:Individual
Prefix:MS
First Name:CHARA
Middle Name:MARIE
Last Name:BOOKER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:CHARA
Other - Middle Name:BOOKER
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78291-0087
Mailing Address - Country:US
Mailing Address - Phone:210-358-9172
Mailing Address - Fax:210-358-9183
Practice Address - Street 1:4647 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4403
Practice Address - Country:US
Practice Address - Phone:210-358-2710
Practice Address - Fax:210-358-4739
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11227452251N0400X
TX1122746225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G1441Medicare ID - Type Unspecified