Individual
RUSANA BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4139 BRIARGLEN, SAN ANTONIO, TX 78218-1521
(210) 590-8927
Mailing address
4139 BRIARGLEN, SAN ANTONIO, TX 78218-1521
(210) 590-8927
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
141582
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105931
STATE LICENSE ASSISTED LIVING
TX
Enumeration date
11/17/2015
Last updated
11/17/2015
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