Organization
OPTIMUM PHYSIO
Active
Other names
OPTIMUM PHYSIO, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SONIA DE ANDA (ADMINISTRATOR)
(210) 314-6725
Entity
Organization
Contact information
Practice address
2322 SAN PEDRO AVE, SAN ANTONIO, TX 78212
(210) 314-6725
(210) 957-8585
Mailing address
2322 SAN PEDRO AVE, SAN ANTONIO, TX 78212-3237
(210) 314-6725
(210) 957-8585
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
675820000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3516395
—
TX
Enumeration date
04/02/2014
Last updated
02/26/2021
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