Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 1148686 | TX |
N | 2251P0200X | Physical Therapist - Pediatrics | 1148686 | TX |
NPI | 1750493037 |
---|---|
Provider Name | Ms. Heather Jill Vann |
First Address | San Antonio, TX 78209-1886 |
Second Address | San Antonio, TX 78239-1980 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
75285003678239A011 | TRICARE (01) | TX |
8T2126 | BCBS (01) | TX |