Provider Demographics
NPI:1285119479
Name:BEHRINGER, CAROLINE MARIE (PTA)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:MARIE
Last Name:BEHRINGER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:KRISCHKE
Other - Last Name:BEHRINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:857 N MONROE ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-1641
Mailing Address - Country:US
Mailing Address - Phone:979-966-9933
Mailing Address - Fax:
Practice Address - Street 1:701 N SARAH DEWITT DR
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:TX
Practice Address - Zip Code:78629-2813
Practice Address - Country:US
Practice Address - Phone:830-672-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2003844225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant