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Individual

MRS. GLADYS M KOVAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
804 MONTICELLO CT, SAN ANTONIO, TX 78223-2232
(210) 534-9451
Mailing address
804 MONTICELLO CT, SAN ANTONIO, TX 78223-2232
(210) 534-9451

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
118485
TX
311ZA0620X
Adult Care Home Facility
Primary
146005
TX

Other

Enumeration date
01/24/2007
Last updated
04/26/2019
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