Provider Demographics
NPI:1891094280
Name:AREVALO, YURI (OTR)
Entity Type:Individual
Prefix:
First Name:YURI
Middle Name:
Last Name:AREVALO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 JENICA CIR S
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-4034
Mailing Address - Country:US
Mailing Address - Phone:956-460-2567
Mailing Address - Fax:956-668-7183
Practice Address - Street 1:2108 S M ST STE 6
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1556
Practice Address - Country:US
Practice Address - Phone:956-668-7433
Practice Address - Fax:956-668-7183
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113537225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist