Individual
AGUSTIN MELENDEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
4301 BROADWAY ST, SAN ANTONIO, TX 78209-6318
(210) 829-3834
Mailing address
15651 CHASE HILL BLVD APT 1510, SAN ANTONIO, TX 78256-1070
(409) 457-5817
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7692
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT7692
TEXAS DEPARTMENT OF LICENSING & REGULATION
TX
Enumeration date
10/24/2018
Last updated
10/24/2018
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