Individual
MR. DAVID CLINTON MICHNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7220 LOUIS PASTEUR DR STE 160, 4319 MEDICAL DR. 131-113, SAN ANTONIO, TX 78229-4535
(210) 614-3003
(210) 692-7898
Mailing address
7220 LOUIS PASTEUR DR, SUITE 160, SAN ANTONIO, TX 78229-4537
(210) 614-3003
(210) 692-7898
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1061299
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T1981
BCBS PROVIDER NUMBER
TX
Enumeration date
08/04/2006
Last updated
07/09/2007
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