Provider Demographics
NPI:1528046950
Name:MORRISON, DONNA CAMILLE (PT)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:CAMILLE
Last Name:MORRISON
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 1:4646 CORONA DR
Mailing Address - Street 2:STE 130
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411
Mailing Address - Country:US
Mailing Address - Phone:361-225-2539
Mailing Address - Fax:361-225-0851
Practice Address - Street 1:4646 CORONA DR
Practice Address - Street 2:STE 130
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-225-2539
Practice Address - Fax:361-225-0851
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142257225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y24392Medicare UPIN
8D1925Medicare ID - Type Unspecified