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Individual

ALICIA DANIELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
8715 VILLAGE DR, SUITE#514, SAN ANTONIO, TX 78217-5405
(210) 637-0641
(210) 637-0613
Mailing address
8715 VILLAGE DR, SUITE#514, SAN ANTONIO, TX 78217-5405
(210) 637-0641
(210) 637-0613

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03865
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8N8803
BLUECROSS/BLUESHIELD TX
TX
Enumeration date
07/21/2006
Last updated
07/16/2007
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