Provider Demographics
NPI:1922293422
Name:EIFE, ROBERTA ANN (OTR)
Entity Type:Individual
Prefix:
First Name:ROBERTA
Middle Name:ANN
Last Name:EIFE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 E SUNSHINE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-2948
Mailing Address - Country:US
Mailing Address - Phone:210-888-2726
Mailing Address - Fax:
Practice Address - Street 1:1418 E SUNSHINE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-2948
Practice Address - Country:US
Practice Address - Phone:210-888-2726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-08
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109236225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist