Individual
CHAD WAYNE SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
21702 LAWREY DR, SAN ANTONIO, TX 78259-2039
(210) 632-5200
Mailing address
21702 LAWREY DR, SAN ANTONIO, TX 78259-2039
(210) 632-5200
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2301
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050502001
BOARD OF CERTIFICATION
—
01
—
AT2301
TEXAS DEPARTMENT OF STATE HEALTH SERVICES
TX
Enumeration date
08/20/2013
Last updated
08/20/2013
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