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Individual

MS. AIDE MARIE AGNEW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4019 STAHL RD, STE: 106, SAN ANTONIO, TX 78217
(210) 300-2414
Mailing address
4019 STAHL RD, STE: 106, SAN ANTONIO, TX 78217
(210) 300-2414

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
332BX2000X
Oxygen Equipment & Supplies (DME)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32-005602241
TAX PAYER II
TX
Enumeration date
01/29/2009
Last updated
01/29/2009
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