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General NPI Number Information
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NPI Number | 1093710758
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Entity Type | Individual
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Provider Name | TERESITA MOURET BROTHERS M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 8109 FREDERICKSBURG RD
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3311
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Country | US
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Telephone | 210-575-0250
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Fax | 210-575-0258
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Provider Business Mailing Address
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Address Line | 2727 TREBLE CRK APT 724
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4555
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Country | US
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Telephone |
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Fax |
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | H1049
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License Number State | TX
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