Individual
GINA MARIE BACCARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.C.P.,S.A.-C.,LSA
Contact information
Practice address
3463 MAGIC DR, SUITE T21, SAN ANTONIO, TX 78229-2973
(210) 614-8101
(210) 614-8102
Mailing address
6742 MANOR HL, SAN ANTONIO, TX 78257-1107
(210) 698-9573
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
FPF00000207
TX
246ZC0007X
Surgical Assistant
Primary
SA00526
TX
Other
Enumeration date
02/01/2007
Last updated
08/19/2019
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