Healthcare Provider Details

I. General information

NPI: 1598035693
Provider Name (Legal Business Name): HUNTER GOLDEN HAIGHT P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2012
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8103 NORTH HOLW
SAN ANTONIO TX
78240-2387
US

IV. Provider business mailing address

8103 N HOLLOW
SAN ANTONIO TX
78240
US

V. Phone/Fax

Practice location:
  • Phone: 210-558-9001
  • Fax: 210-558-9010
Mailing address:
  • Phone: 210-558-9001
  • Fax: 210-558-9010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number1158367
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: