Provider Demographics
NPI:1497055479
Name:WEISS, DEBORAH (BA,MPT,MSCS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:BA,MPT,MSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 BENTON WOODS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4494
Mailing Address - Country:US
Mailing Address - Phone:210-573-1386
Mailing Address - Fax:
Practice Address - Street 1:1542 BENTON WOODS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4494
Practice Address - Country:US
Practice Address - Phone:210-573-1386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1128890225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist