Basic Information
| Provider Information | |||||||||
| NPI: | 1730548520 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MAYES | ||||||||
| FirstName: | DEBORAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 98 BRIGGS ST | ||||||||
| Address2: | #990 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782241286 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102269536 | ||||||||
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| Practice Location | |||||||||
| Address1: | 98 BRIGGS ST | ||||||||
| Address2: | #990 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782241286 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102269536 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2016 | ||||||||
| LastUpdateDate: | 02/22/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 107289 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.