Individual
ELI SAMUEL PEREZ DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
4949 RAVENSWOOD DR, SAN ANTONIO, TX 78227-4320
(210) 673-2761
Mailing address
4949 RAVENSWOOD DR, SAN ANTONIO, TX 78227-4320
(210) 673-2761
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
217847
TX
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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