MEDICARE: MS. PATRICIA VINTON OTR

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	225X00000X	Occupational Therapist	112335	TX

General Provider Information

NPI Number	:	1700160140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA VINTON OTR

Provider Business Mailing Address
First Line	:	7402 CHENAL PT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3074
Country	:	US
Telephone Number	:	210-710-4604
Fax Number	:

Provider Business Practice Location Address
First Line	:	7402 CHENAL PT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-3074
Country	:	US
Telephone Number	:	210-710-4604
Fax Number	:

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

Provider Enumeration Date	:	10/04/2011
Last Update Date	:	10/04/2011

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