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1275154882
SHASTA THEODORE
SAN ANTONIO, TX
NPI
1275154882
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-05-05
Last Update Date
2020-05-05
Business Address
SHASTA THEODORE MD
7703 FLOYD CURL DR # MC7750
SAN ANTONIO, TX 78229-3901
Phone number: 936-446-0466
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Mailing Address
SHASTA THEODORE MD
7703 FLOYD CURL DR # MC7750
SAN ANTONIO, TX 78229-3901
Phone number: 936-446-0466
Copy
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