Provider Demographics
NPI:1184984999
Name:SARMIENTO, IRENE CAROLINA (OTR)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:CAROLINA
Last Name:SARMIENTO
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 1:1101 W DOVE AVE
Mailing Address - Street 2:APT 17
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3576
Mailing Address - Country:US
Mailing Address - Phone:407-227-8517
Mailing Address - Fax:
Practice Address - Street 1:615 N WARE RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8057
Practice Address - Country:US
Practice Address - Phone:956-644-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-26
Last Update Date:2012-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113732225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist