Bourque, Mamawah Isata

Bourque, Mamawah Isata is an sole proprietor health care provider with primary practice located at 14332 Montfort Dr #4101, Dallas TX 75254-8486. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Bourque, Mamawah Isata can be contacted via phone (713) 256-4708.

Contact Information

Primary practice address
14332 Montfort Dr #4101 Dallas TX 75254-8486
Phone: (713) 256-4708
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1210663 Texas

Profile Details

NPI number 1053659649
LBN Legal business name Bourque, Mamawah Isata
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2013
Last updated Jan 16th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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