Healthcare Provider Details

I. General information

NPI: 1730352865
Provider Name (Legal Business Name): SHERYL NOCITO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15320 MAIN
LYTLE TX
78052
US

IV. Provider business mailing address

14220 NORTHBROOK STE 700
SAN ANTONIO TX
78232
US

V. Phone/Fax

Practice location:
  • Phone: 830-709-5777
  • Fax: 830-709-0103
Mailing address:
  • Phone: 210-822-8807
  • Fax: 210-822-8863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1033744
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: