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General NPI Number Information
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NPI Number | 1609741826
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Entity Type | Individual
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Provider Name | MICHAEL MOONEY
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Gender | Male
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 5000 FAWN MEADOW CIRCLE
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City | SAN ANTONIO
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State | TX
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Zip | 78240
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Country | US
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Telephone | 210-696-9744
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Fax |
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Provider Business Mailing Address
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Address Line | 8203 VALLECITO RUN
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City | SAN ANTONIO
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State | TX
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Zip | 78250-2213
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Country | US
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Telephone | 325-647-7863
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2166815
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License Number State | TX
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