Individual
NINA LUM FRU BAUMGARTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7710 W1H 10, SAN ANTONIO, TX 78230
(210) 377-3355
Mailing address
10419 EAGLE FOX, SAN ANTONIO, TX 78245-1039
(210) 992-5972
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NA0010659164
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2109925972
2109925972
TX
01
—
5972
5972
TX
01
—
5972
5972
—
Enumeration date
08/21/2018
Last updated
08/21/2018
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