Provider Demographics
NPI:1558150003
Name:CORRAL, ALEXIS (ATC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:CORRAL
Suffix:
Gender:
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:DELL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79837-0062
Mailing Address - Country:US
Mailing Address - Phone:915-342-0903
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 62
Practice Address - Street 2:
Practice Address - City:DELL CITY
Practice Address - State:TX
Practice Address - Zip Code:79837-0062
Practice Address - Country:US
Practice Address - Phone:915-342-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer