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General NPI Number Information
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NPI Number | 1316459498
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Entity Type | Organization
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Legal Business Name | THE BRAIN GYM, INC.
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Dates
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Enumeration Date | 10/30/2017
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 700 E SONTERRA BLVD STE 307
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4386
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Country | US
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Telephone | 210-967-6278
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Fax |
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Provider Business Mailing Address
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Address Line | 700 E SONTERRA BLVD STE 307
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4386
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Country | US
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Telephone | 210-967-6278
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MRS. GINA SUZANNE CRUZ
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Credential | M.ED., ED. DIAG,BCCS
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Telephone | 210-967-6278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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