Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 1328491 | TX |
Y | 2251P0200X | Physical Therapist - Pediatrics | 1328491 | TX |
N | 2251X0800X | Physical Therapist - Orthopedic | 1328491 | TX |
NPI | 1316570864 |
---|---|
Provider Name | Amara Smith |
First Address | San Antonio, TX 78201-0302 |
Second Address | San Antonio, TX 78201-6234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2020 |
Last Update Date | 12/02/2020 |