Provider Demographics
NPI:1316261860
Name:AMARAL, MICHAEL DAVID (PT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:AMARAL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2922 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8686
Mailing Address - Country:US
Mailing Address - Phone:956-739-3757
Mailing Address - Fax:956-425-5777
Practice Address - Street 1:2922 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8686
Practice Address - Country:US
Practice Address - Phone:956-739-3757
Practice Address - Fax:956-425-5777
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1022960225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX365490702Medicaid