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General NPI Number Information
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NPI Number | 1144501321
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Entity Type | Individual
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Provider Name | GILBERT L PERALES MOT, OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 3550 PUESTA DE SOL
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City | SAN ANTONIO
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State | TX
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Zip | 78261-2415
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Country | US
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Telephone | 210-544-2630
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Fax |
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Provider Business Mailing Address
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Address Line | 3550 PUESTA DE SOL
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City | SAN ANTONIO
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State | TX
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Zip | 78261-2415
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Country | US
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Telephone | 210-544-2630
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 113083
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License Number State | TX
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