Healthcare Provider Details

I. General information

NPI: 1386319721
Provider Name (Legal Business Name): DANIELA ESCOBEDO URIBE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2021
Last Update Date: 08/09/2021
Certification Date: 08/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20821 US HIGHWAY 281 N STE 110
SAN ANTONIO TX
78258-7594
US

IV. Provider business mailing address

8627 CINNAMON CREEK DR STE 402
SAN ANTONIO TX
78240-1482
US

V. Phone/Fax

Practice location:
  • Phone: 210-610-4480
  • Fax: 210-334-0948
Mailing address:
  • Phone: 210-372-9600
  • Fax: 210-392-9923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1348556
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: