Individual
MR. LARRY TIJERINA DURON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
2203 BABCOCK RD, SAN ANTONIO, TX 78229-4412
(210) 614-3911
(210) 616-0433
Mailing address
2203 BABCOCK RD, SAN ANTONIO, TX 78229-4412
(210) 614-3911
(210) 616-0443
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
112314
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112314
PROFESSIONAL LICENSE
TX
Enumeration date
07/07/2008
Last updated
09/18/2013
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