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1619704947
MARY THERESA FANTAZIA
FORT CAVAZOS, TX
NPI
1619704947
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: TX 1170828)
Enumeration Date
2024-09-19
Last Update Date
2024-09-19
Business Address
MARY THERESA FANTAZIA DNP
590 MEDICAL CENTER ROAD
FORT CAVAZOS, TX 76544-5060
Phone number: 254-288-8000
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Mailing Address
MARY THERESA FANTAZIA DNP
2706 W HUISACHE AVE
SAN ANTONIO, TX 78228-5003
Phone number: 260-624-4757
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