Individual
AMBER FRAGOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1 CAMINO SANATA MARIA, SAN ANTONIO, TX 78228
(210) 436-3101
Mailing address
5313 SUNMEADOW DR, PLAINFIELD, IL 60586-7585
(815) 592-0890
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT6838
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT6838
LICENSED ATHLETIC TRAINER
TX
Enumeration date
04/20/2017
Last updated
04/20/2017
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