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NPI Code Detail

MEDICARE: CRYSTAL ANN WOSTAREK

MEDICARE: CRYSTAL ANN WOSTAREK
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 Assistant2048066TX

General Provider Information

NPI Number : 1518504380
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL ANN WOSTAREK
Provider Business Mailing Address
First Line : 4321 E FM 1518 N
Second Line :
City : SAINT HEDWIG
State : TX
Zip : 78152-9747
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 636 CUPPLES RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78237-4328
Country : US
Telephone Number : 210-237-1883
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2019
Last Update Date : 11/28/2019

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Directions to “ CRYSTAL ANN WOSTAREK ” Practice Location

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