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General NPI Number Information
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NPI Number | 1649884784
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Entity Type | Individual
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Provider Name | ANGEL SAUL VAZQUEZ
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Gender | Male
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Dates
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Enumeration Date | 09/05/2020
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2335 E SAUNDERS ST
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City | LAREDO
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State | TX
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Zip | 78041-5434
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Country | US
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Telephone | 956-791-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 9802 SEQUIN CT
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City | LAREDO
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State | TX
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Zip | 78045-6364
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Country | US
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Telephone | 956-771-9038
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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 | 2155012
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT142891
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License Number State | TX
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