Healthcare Provider Details

I. General information

NPI: 1225242340
Provider Name (Legal Business Name): THOMAS TOBIN OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8930 FOURWINDS DR SUITE 101
SAN ANTONIO TX
78239-1970
US

IV. Provider business mailing address

23230 HANGING OAK
SAN ANTONIO TX
78266-1701
US

V. Phone/Fax

Practice location:
  • Phone: 210-495-8788
  • Fax: 210-495-8212
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number104359
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: