Provider Demographics
NPI:1578814380
Name:MEDRANO, ASHLEY RENEE (DPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:MEDRANO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10415 STATE HIGHWAY 151
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4552
Mailing Address - Country:US
Mailing Address - Phone:210-647-9970
Mailing Address - Fax:210-647-7229
Practice Address - Street 1:10415 STATE HIGHWAY 151
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4552
Practice Address - Country:US
Practice Address - Phone:210-647-9970
Practice Address - Fax:210-647-7229
Is Sole Proprietor?:No
Enumeration Date:2012-09-20
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1219297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1219297OtherPHYSICAL THERAPY LICENSE