Provider Demographics
NPI:1790750206
Name:PRIETO, JULIE DALE (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:DALE
Last Name:PRIETO
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:DALE
Other - Last Name:CALVERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAT
Mailing Address - Street 1:1760 BARKER CYPRESS RD
Mailing Address - Street 2:APT. 734
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6152
Mailing Address - Country:US
Mailing Address - Phone:281-599-8415
Mailing Address - Fax:
Practice Address - Street 1:1760 BARKER CYPRESS RD
Practice Address - Street 2:APT. 734
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6152
Practice Address - Country:US
Practice Address - Phone:281-599-8415
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT32072255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer