Provider Demographics
NPI:1528395142
Name:MCEACHERN, NORMA ANN (PTA)
Entity Type:Individual
Prefix:MS
First Name:NORMA
Middle Name:ANN
Last Name:MCEACHERN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WINGATE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78204-2048
Mailing Address - Country:US
Mailing Address - Phone:210-225-1865
Mailing Address - Fax:
Practice Address - Street 1:110 WINGATE AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78204-2048
Practice Address - Country:US
Practice Address - Phone:210-225-1865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2067758225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant