Provider Demographics
NPI:1982343521
Name:PADILLA, KRYSTIANE CAMILLE (AUD)
Entity Type:Individual
Prefix:DR
First Name:KRYSTIANE
Middle Name:CAMILLE
Last Name:PADILLA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13002 RAMBLING OAK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5162
Mailing Address - Country:US
Mailing Address - Phone:210-779-7910
Mailing Address - Fax:
Practice Address - Street 1:18518 HARDY OAK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4762
Practice Address - Country:US
Practice Address - Phone:210-696-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81371231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist