Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2021820 | TX |
NPI | 1013187954 |
---|---|
Provider Name | Mr. Andrew Solis |
First Address | San Antonio, TX 78229-3931 |
Second Address | San Antonio, TX 78251-1476 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2008 |
Last Update Date | 03/11/2011 |