MEDICARE: CHRISTIONNA NICHOL SHUMAN-BATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT129508	TX

General Provider Information

NPI Number	:	1124600085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIONNA NICHOL SHUMAN-BATES

Provider Business Mailing Address
First Line	:	5707 TPC PKWY APT 1435
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78261-2794
Country	:	US
Telephone Number	:	210-367-2967
Fax Number	:

Provider Business Practice Location Address
First Line	:	5707 TPC PKWY APT 1435
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78261-2794
Country	:	US
Telephone Number	:	210-367-2967
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2021
Last Update Date	:	04/21/2021

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Directions to “ CHRISTIONNA NICHOL SHUMAN-BATES ” Practice Location

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