Individual
ELSY JEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRANIAL PROTHESIS
Contact information
Practice address
6107 LAKEFRONT ST, SAN ANTONIO, TX 78222-1523
(772) 267-2087
Mailing address
1721 S WW WHITE RD, SAN ANTONIO, TX 78220-1517
(772) 267-2087
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
8HOQM7Y1RI
TX
Other
Enumeration date
05/08/2024
Last updated
05/08/2024
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