Provider Demographics
NPI:1700410560
Name:CARRANZA, CATHRYN RENEE
Entity Type:Individual
Prefix:
First Name:CATHRYN
Middle Name:RENEE
Last Name:CARRANZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 REVERE ST APT 5022
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1392
Mailing Address - Country:US
Mailing Address - Phone:956-463-7420
Mailing Address - Fax:
Practice Address - Street 1:2727 REVERE ST APT 5022
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1392
Practice Address - Country:US
Practice Address - Phone:956-463-7420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer