Individual
MINETTE BAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
1 S FORT RINGGOLD ST, RIO GRANDE CITY, TX 78582-4701
(956) 370-3415
Mailing address
1 S FORT RINGGOLD ST, RIO GRANDE CITY, TX 78582-4701
(956) 573-8654
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7046
TX
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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