MEDICARE: CHRISTOPHER MALDONADO PT

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	1248227	TX

General Provider Information

NPI Number	:	1861891244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER MALDONADO PT

Provider Business Mailing Address
First Line	:	8627 CINNAMON CREEK DR
Second Line	:	SUITE 402
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1480
Country	:	US
Telephone Number	:	210-695-8731
Fax Number	:	210-598-0432

Provider Business Practice Location Address
First Line	:	7003 S NEW BRAUNFELS AVE
Second Line	:	SUITE 114
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-4588
Country	:	US
Telephone Number	:	210-829-0359
Fax Number	:	210-598-0432

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

Provider Enumeration Date	:	08/21/2014
Last Update Date	:	08/21/2014

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Directions to “ CHRISTOPHER MALDONADO PT” Practice Location

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