Provider Demographics
NPI:1053516179
Name:BRITO, SANDRA (PT)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:BRITO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 S STEWART RD
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-1576
Mailing Address - Country:US
Mailing Address - Phone:956-631-6200
Mailing Address - Fax:956-631-6433
Practice Address - Street 1:3601 BUDDY OWENS BOULEVARD
Practice Address - Street 2:SUITE 100
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-6447
Practice Address - Country:US
Practice Address - Phone:956-631-6200
Practice Address - Fax:956-631-6433
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1075364225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist