Provider Demographics
NPI:1730465774
Name:PAULMA, VISMINDA L
Entity Type:Individual
Prefix:
First Name:VISMINDA
Middle Name:L
Last Name:PAULMA
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 1:9847 GAZELLE FRD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4374
Mailing Address - Country:US
Mailing Address - Phone:210-621-3471
Mailing Address - Fax:
Practice Address - Street 1:7031 EVENING SUN ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1409
Practice Address - Country:US
Practice Address - Phone:210-680-3755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility