Provider Demographics
NPI:1760552772
Name:PAINTER, NORMA (LPTA)
Entity Type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:
Last Name:PAINTER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 RIDGE TRAIL ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1308
Mailing Address - Country:US
Mailing Address - Phone:210-387-4993
Mailing Address - Fax:210-545-7021
Practice Address - Street 1:16911 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2244
Practice Address - Country:US
Practice Address - Phone:210-499-1278
Practice Address - Fax:210-499-1278
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2045904261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy