Provider Demographics
NPI:1831959832
Name:TERRY, PATRICIA (LMT)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:ZIPAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:357 BROOKS DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78408-3315
Mailing Address - Country:US
Mailing Address - Phone:361-815-7330
Mailing Address - Fax:
Practice Address - Street 1:5702 S STAPLES ST STE F-2C
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3784
Practice Address - Country:US
Practice Address - Phone:361-815-7330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT117312225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist