Organization
GMIT TEXAS LLC
Active
Other names
UC4Life Wellness Center- Stone Oak
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB LISERIO TORRES DC (PRESIDENT)
(210) 897-9911
Entity
Organization
Contact information
Practice address
540 MADISON OAK DR, STE. 140, SAN ANTONIO, TX 78258-3943
(210) 529-7090
(210) 579-6729
Mailing address
540 MADISON OAK DR, STE. 140, SAN ANTONIO, TX 78258-3943
(210) 529-7090
(210) 579-6729
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
11313
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689905390
INDIVIDUAL NPI
TX
Enumeration date
02/05/2014
Last updated
02/05/2014
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