Provider Demographics
NPI:1427197714
Name:OATES, JOAN MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARIE
Last Name:OATES
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 1:1431 HAWKS MDW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1572
Mailing Address - Country:US
Mailing Address - Phone:210-493-7872
Mailing Address - Fax:210-479-1461
Practice Address - Street 1:8610 N NEW BRAUNFELS AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6370
Practice Address - Country:US
Practice Address - Phone:210-804-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1091759225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist