Individual
MISS CELESTE THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4775 HAMILTON WOLFE RD STE 1, SAN ANTONIO, TX 78229-3456
(210) 616-0283
(210) 616-0071
Mailing address
4775 HAMILTON WOLFE RD STE 1, SAN ANTONIO, TX 78229-3456
(210) 616-0283
(210) 616-0071
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02892
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211256701
—
TX
Enumeration date
07/24/2006
Last updated
12/13/2011
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