Provider Demographics
NPI:1740023829
Name:FRAUSTO, MICHELLE S
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:FRAUSTO
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 1:10367 MARTIN CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-1717
Mailing Address - Country:US
Mailing Address - Phone:956-204-2146
Mailing Address - Fax:
Practice Address - Street 1:10367 MARTIN CRK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78252-1717
Practice Address - Country:US
Practice Address - Phone:956-204-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant