Individual
KARLA RENEE THIEBAUD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D, P.T.
Contact information
Practice address
1211 ARION PKWY, SUITE 100, SAN ANTONIO, TX 78216-2808
(210) 366-2990
(210) 491-8098
Mailing address
PO BOX 792590, SAN ANTONIO, TX 78279-2590
(210) 366-2990
(210) 491-8098
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1074060
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86158T
BCBS OF TEXAS
TX
Enumeration date
07/20/2005
Last updated
07/08/2007
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