Provider Demographics
NPI:1851978621
Name:RIOS, BRENDA NATHALIE (PT)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:NATHALIE
Last Name:RIOS
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 1:436 NORDSTROM AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79932-1269
Mailing Address - Country:US
Mailing Address - Phone:915-346-2193
Mailing Address - Fax:
Practice Address - Street 1:2301 N OREGON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3216
Practice Address - Country:US
Practice Address - Phone:915-532-8941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1198807225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist