Provider Demographics
NPI:1871238469
Name:PRIETO, YESENIA ELIZABETH (PTA)
Entity Type:Individual
Prefix:
First Name:YESENIA
Middle Name:ELIZABETH
Last Name:PRIETO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:13838 BENEDETTA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-6130
Mailing Address - Country:US
Mailing Address - Phone:210-461-6748
Mailing Address - Fax:
Practice Address - Street 1:5034 NEWFOREST DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5459
Practice Address - Country:US
Practice Address - Phone:210-306-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2127287225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant