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General NPI Number Information
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NPI Number | 1841951902
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Entity Type | Individual
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Provider Name | CARA DANIELLE MARCELLA MED, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 12/31/2021
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 8210 VALLECITO WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78250-2262
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Country | US
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Telephone | 210-410-6935
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Fax |
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Provider Business Mailing Address
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Address Line | 600 N ELLISON DR
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4345
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Country | US
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Telephone | 210-397-6512
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT6204
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License Number State | TX
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