Provider Demographics
NPI:1659505121
Name:SEGURA, KATSUMI C (PT)
Entity Type:Individual
Prefix:
First Name:KATSUMI
Middle Name:C
Last Name:SEGURA
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 1:20649 PERRY RD
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-2172
Mailing Address - Country:US
Mailing Address - Phone:956-792-6018
Mailing Address - Fax:
Practice Address - Street 1:20649 PERRY RD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-2172
Practice Address - Country:US
Practice Address - Phone:956-792-6018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1070084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist