Provider Demographics
NPI:1528224730
Name:FEIST, MARI BOTELLO (PT)
Entity Type:Individual
Prefix:
First Name:MARI
Middle Name:BOTELLO
Last Name:FEIST
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 1:4241 WOODCOCK DR
Mailing Address - Street 2:STE. A-100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1328
Mailing Address - Country:US
Mailing Address - Phone:210-785-5200
Mailing Address - Fax:
Practice Address - Street 1:4241 WOODCOCK DR
Practice Address - Street 2:STE. A-100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1328
Practice Address - Country:US
Practice Address - Phone:210-785-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1043065225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist