Healthcare Provider Details

I. General information

NPI: 1255445193
Provider Name (Legal Business Name): CHERYL OBREGON P.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E. SONTERRA BLVD SUITE 300
SAN ANTONIO TX
78258
US

IV. Provider business mailing address

150 E. SONTERRA BLVD SUITE 300
SAN ANTONIO TX
78258
US

V. Phone/Fax

Practice location:
  • Phone: 210-489-7270
  • Fax: 210-403-2445
Mailing address:
  • Phone: 210-489-7270
  • Fax: 210-403-2445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number1156488
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: