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NPI Code Detail

MEDICARE: ANA GABRIELA GAITAN LMT

MEDICARE: ANA GABRIELA GAITAN LMT
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
1225700000XMassage Therapist121427TX

General Provider Information

NPI Number : 1124671946
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA GABRIELA GAITAN LMT
Provider Business Mailing Address
First Line : 14802 JONES MALTSBERGER RD STE 1101
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-3571
Country : US
Telephone Number : 210-315-3684
Fax Number :
Provider Business Practice Location Address
First Line : 14802 JONES MALTSBERGER RD STE 1101
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-3571
Country : US
Telephone Number : 210-315-3684
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2019
Last Update Date : 07/21/2019

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Directions to “ ANA GABRIELA GAITAN LMT” Practice Location

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