Shannon Quintero, PTA

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Anson, TX

NPI 1184070997 · NPPES record last updated Jan 12, 2022

Key facts

NPI
1184070997
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
101 Liberty LN
Anson, TX 79501-2197
Phone
(325) 823-2141
NPI assigned
May 11, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
26913FLMDPhysical Therapy Assistant
2167050TXMDPhysical Therapy Assistant

Networks

  • Freedom Health HMO Network

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2167050 TX
Physical Therapy Assistant 225200000X 26913 FL
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

101 Liberty LN
Anson, TX 79501-2197

Mailing address

1061 NW 46TH PL
Ocala, FL 34475-9574
Phone (321) 696-5158

Other practice location 1

1565 Saxon Blvd Ste 301
Deltona, FL 32725-5836
Phone (386) 851-0901

Other providers in Anson, TX

All providers in Anson, TX · Student in an Organized Health Care Education/Training Program in Texas

Sources for this page

Verify at the official NPI Registry.