Healthcare Provider Details

I. General information

NPI: 1932746674
Provider Name (Legal Business Name): JOSEPH ANTHONY AMARO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2019
Last Update Date: 07/02/2021
Certification Date: 07/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 JOHN SMITH DR STE 108
SAN ANTONIO TX
78229-6069
US

IV. Provider business mailing address

7410 JOHN SMITH DR STE 108
SAN ANTONIO TX
78229-6069
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-3804
  • Fax: 210-614-3805
Mailing address:
  • Phone: 210-614-3804
  • Fax: 210-614-3805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225CA2500X
TaxonomyAssistive Technology Supplier Rehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: