MEDICARE: VICTORIA OLMOS

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	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1487239307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA OLMOS

Provider Business Mailing Address
First Line	:	5720 BANDERA RD STE 14
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1950
Country	:	US
Telephone Number	:	210-298-8866
Fax Number	:

Provider Business Practice Location Address
First Line	:	5720 BANDERA RD STE 14
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1950
Country	:	US
Telephone Number	:	210-298-8866
Fax Number	:

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

Provider Enumeration Date	:	03/11/2021
Last Update Date	:	03/12/2021

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Directions to “ VICTORIA OLMOS ” Practice Location

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