Healthcare Provider Details

I. General information

NPI: 1083844575
Provider Name (Legal Business Name): AIMEE MOREAU ANTHONY DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 COMMON ST SUITE 307
NEW BRAUNFELS TX
78130-3565
US

IV. Provider business mailing address

24385 WILDERNESS OAK APT. 7301
SAN ANTONIO TX
78258
US

V. Phone/Fax

Practice location:
  • Phone: 830-625-7310
  • Fax:
Mailing address:
  • Phone: 504-914-7946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1189137
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: