Provider Demographics
NPI:1114811106
Name:VIRGEL, FAITH NICHOLE (MAT, ATC, LAT)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:NICHOLE
Last Name:VIRGEL
Suffix:
Gender:F
Credentials:MAT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 BLOSSOMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6206
Mailing Address - Country:US
Mailing Address - Phone:979-824-3807
Mailing Address - Fax:
Practice Address - Street 1:412 BLOSSOMWOOD DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6206
Practice Address - Country:US
Practice Address - Phone:979-798-6196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20000572082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer