Individual
MRS. TARA WATAMALEO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
626 CHAMOMILE, SAN ANTONIO, TX 78245-2413
(210) 912-8715
Mailing address
626 CHAMOMILE, SAN ANTONIO, TX 78245-2413
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
12/09/2009
Last updated
12/09/2009
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