Provider Demographics
NPI:1992539704
Name:BRIONES, PEDRO III
Entity type:Individual
Prefix:
First Name:PEDRO
Middle Name:
Last Name:BRIONES
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7106 HELENA HL
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-3157
Mailing Address - Country:US
Mailing Address - Phone:214-903-9443
Mailing Address - Fax:
Practice Address - Street 1:1870 JOHN KING BLVD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6216
Practice Address - Country:US
Practice Address - Phone:972-722-7408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2122106225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant