Provider Demographics
NPI:1376520767
Name:BREWER, MICHELLE ANNETTE (PT)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANNETTE
Last Name:BREWER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CONCORD PLAZA DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6991
Mailing Address - Country:US
Mailing Address - Phone:210-804-5400
Mailing Address - Fax:210-678-4142
Practice Address - Street 1:400 CONCORD PLAZA DR STE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6995
Practice Address - Country:US
Practice Address - Phone:210-804-5531
Practice Address - Fax:210-804-5501
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1156567225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist