Individual
LISA BAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, LAT, ATC, CES
Contact information
Practice address
1 UTSA CIR, SAN ANTONIO, TX 78249-1644
(714) 783-6436
Mailing address
5072 TIMBERHILL APT 4101, SAN ANTONIO, TX 78238-3565
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7864
TX
Other
Enumeration date
01/23/2019
Last updated
11/29/2021
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