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General NPI Number Information
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NPI Number | 1528650892
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Entity Type | Organization
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Legal Business Name | DVGS, LLC
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Dates
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Enumeration Date | 02/08/2021
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Last Update Date | 02/08/2021
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Provider Practice Location Address
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Address Line | 6322 FM 78 STE 117
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City | SAN ANTONIO
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State | TX
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Zip | 78244-1033
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Country | US
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Telephone | 210-316-4836
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Fax |
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Provider Business Mailing Address
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Address Line | 7219 GLEN ELLEN BAY
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City | SAN ANTONIO
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State | TX
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Zip | 78244-1757
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Country | US
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Telephone | 210-316-4836
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. RICARDO ALBERTO BARNETT
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Credential |
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Telephone | 210-316-4836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number |
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License Number State |
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