MEDICARE: MRS. ELAINE RODRIGUEZ GARZA PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1150382	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902950793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELAINE RODRIGUEZ GARZA PT

Provider Business Mailing Address
First Line	:	3131 MAYFAIR DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-3930
Country	:	US
Telephone Number	:	210-241-7975
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 CENTRAL PKWY S
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-5021
Country	:	US
Telephone Number	:	210-798-2273
Fax Number	:	210-495-1479

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	03/20/2013

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