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Individual

BROOKE LOERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-4141
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 316-4844

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1325826
TX
2251P0200X
Pediatric Physical Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
273955978
TAX ID
Enumeration date
12/09/2019
Last updated
05/20/2021
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