Individual
MARIO VASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2040 BABCOCK RD STE 304, SAN ANTONIO, TX 78229-4428
(210) 731-9570
Mailing address
1047 LAZAR DR, EAGLE PASS, TX 78852-5600
(830) 469-8000
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
319710
TX
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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