Individual
SHANNA LOUIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4211 GARDENDALE ST STE 200A, SAN ANTONIO, TX 78229-3529
(210) 615-7837
Mailing address
PO BOX 1146, LA VERNIA, TX 78121-1146
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2039030
TX
225200000X
Physical Therapy Assistant
2039030
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124259502
—
TX
05
—
1578708483
—
TX
Enumeration date
09/05/2018
Last updated
09/05/2018
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