MEDICARE: DEBORAH WEISS BA,MPT,MSCS

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	1128890	TX

General Provider Information

NPI Number	:	1497055479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH WEISS BA,MPT,MSCS

Provider Business Mailing Address
First Line	:	1542 BENTON WOODS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4494
Country	:	US
Telephone Number	:	210-573-1386
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 BENTON WOODS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4494
Country	:	US
Telephone Number	:	210-573-1386
Fax Number	:

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

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	07/30/2012

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