Provider Demographics
NPI:1639248594
Name:OBERMILLER, CATHY
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:OBERMILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 MOORESHILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5913
Mailing Address - Country:US
Mailing Address - Phone:210-679-5620
Mailing Address - Fax:
Practice Address - Street 1:9150 HUEBNER RD STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1545
Practice Address - Country:US
Practice Address - Phone:210-561-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2038594OtherLICENSE#