Individual
DEBRA THREAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 N RIO GRANDE, SAN ANTONIO, TX 78202-3265
(210) 644-8701
Mailing address
210 N RIO GRANDE, SAN ANTONIO, TX 78202-3265
(210) 644-8701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
242224
TX
Other
Enumeration date
07/12/2011
Last updated
07/12/2011
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