Provider Demographics
NPI:1962045807
Name:GATHRIGHT, BRIANNA MICHELE
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MICHELE
Last Name:GATHRIGHT
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 1:5122 SPRING BROOK DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5629
Mailing Address - Country:US
Mailing Address - Phone:361-461-3571
Mailing Address - Fax:
Practice Address - Street 1:101 N UPPER BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-2756
Practice Address - Country:US
Practice Address - Phone:361-461-3571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13049422251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics