Individual
MS. STEPHANIE ELIZABETH INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
15600 SAN PEDRO AVE, STE. 307, SAN ANTONIO, TX 78232-3740
(210) 494-2343
Mailing address
6903 BORDER BROOK, APT. 802, SAN ANTONIO, TX 78238
(210) 542-2922
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2047926
TX
Other
Enumeration date
07/18/2007
Last updated
07/18/2007
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