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General NPI Number Information
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NPI Number | 1063888725
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Entity Type | Individual
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Provider Name | VANESSA OLIVA DPT
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Gender | Female
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 7555 NW LOOP 410 SUITE 114
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City | SAN ANTONIO
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State | TX
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Zip | 78245-2353
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Country | US
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Telephone | 210-521-7054
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Fax | 210-520-8573
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Provider Business Mailing Address
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Address Line | 12003 AGNEW RDG
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City | SAN ANTONIO
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State | TX
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Zip | 78254-5010
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Country | US
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Telephone | 210-844-2926
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Fax | 210-520-8573
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1264596
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License Number State | TX
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