MEDICARE: ABISOLA SANTOS P.T., M.B.A.

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	225100000X	Physical Therapist	1161150	TX

General Provider Information

NPI Number	:	1346303955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABISOLA SANTOS P.T., M.B.A.

Provider Business Mailing Address
First Line	:	19950 HUEBNER RD
Second Line	:	APARTMENT 1101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3292
Country	:	US
Telephone Number	:	210-957-1651
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 TOWERS PARK LN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-6410
Country	:	US
Telephone Number	:	210-841-7789
Fax Number	:

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	02/12/2011

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