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NPI Code Detail

MEDICARE: MR. BERNADINO PRIETO

MEDICARE: MR. BERNADINO PRIETO
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
1225200000XPhysical Therapy AssistantTX

General Provider Information

NPI Number : 1134601065
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BERNADINO PRIETO
Provider Business Mailing Address
First Line : 12137 STRATSBURG
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78252-4410
Country : US
Telephone Number : 210-596-3917
Fax Number :
Provider Business Practice Location Address
First Line : 5100 JOHN D RYAN BLVD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78245-3527
Country : US
Telephone Number : 210-596-3917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2018
Last Update Date : 09/06/2018

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Directions to “ MR. BERNADINO PRIETO ” Practice Location

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