Individual
MR. ANDREW SHIBATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, ATC, LAT
Contact information
Practice address
ONE UTSA CIRCLE, SAN ANTONIO, TX 78249-1644
(210) 458-6918
Mailing address
7575 CALLAGHAN RD APT 1014, SAN ANTONIO, TX 78229-2878
(818) 481-0866
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7774
TX
Other
Enumeration date
12/21/2019
Last updated
12/21/2019
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