Provider Demographics
NPI:1538842919
Name:RIBEIRO, CARLA (LMT)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3880 GREENHOUSE RD STE 404
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3486
Mailing Address - Country:US
Mailing Address - Phone:281-302-8898
Mailing Address - Fax:
Practice Address - Street 1:3880 GREENHOUSE RD STE 404
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3486
Practice Address - Country:US
Practice Address - Phone:346-298-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117813225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty