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NPI Code Detail

MEDICARE: MRS. ELIZABETH ANNE MENCHACA P.T.

MEDICARE: MRS. ELIZABETH ANNE MENCHACA P.T.
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
1225100000XPhysical Therapist1168991TX

General Provider Information

NPI Number : 1720122682
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH ANNE MENCHACA P.T.
Provider Business Mailing Address
First Line : 12952 BANDERA RD
Second Line : SUITE 107
City : HELOTES
State : TX
Zip : 78023-4689
Country : US
Telephone Number : 210-372-9600
Fax Number : 210-372-0211
Provider Business Practice Location Address
First Line : 11219 POTRANCO RD
Second Line : BLDG A STE 110
City : SAN ANTONIO
State : TX
Zip : 78253-5848
Country : US
Telephone Number : 210-679-6900
Fax Number : 210-679-6904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2007
Last Update Date : 04/29/2011

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