Provider Demographics
NPI:1063252369
Name:SALAS, BRENDA (PT,DPT,CBIS, CERTDN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:SALAS
Suffix:
Gender:F
Credentials:PT,DPT,CBIS, CERTDN
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:EGGINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:810 CHESTNUT KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5275
Mailing Address - Country:US
Mailing Address - Phone:832-970-7652
Mailing Address - Fax:
Practice Address - Street 1:810 CHESTNUT KNOLL LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5275
Practice Address - Country:US
Practice Address - Phone:832-970-7652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist