Provider Demographics
NPI:1205218633
Name:DESCHAINE, MONICA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:MARIE
Last Name:DESCHAINE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31031 KEENELAND DR
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS RANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78015-4247
Mailing Address - Country:US
Mailing Address - Phone:210-643-4600
Mailing Address - Fax:
Practice Address - Street 1:1248 AUSTIN HWY
Practice Address - Street 2:UNIT 210
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-4821
Practice Address - Country:US
Practice Address - Phone:210-946-1753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3117847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist