Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1032340 | TX |
NPI | 1033690185 |
---|---|
Provider Name | Manuel Huerta |
First Address | San Antonio, TX 78254-2544 |
Second Address | San Antonio, TX 78254-2544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2018 |
Last Update Date | 27/08/2018 |