1942553961 NPI number — ANITA MARIE OEHMKE PT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942553961 NPI number — ANITA MARIE OEHMKE PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OEHMKE
Provider First Name:
ANITA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARCIA
Provider Other First Name:
ANITA
Provider Other Middle Name:
OEHMKE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942553961
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1045 CENTRAL PARKWAY NORTH
Provider Second Line Business Mailing Address:
SUITE #200
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78232-5024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-541-4500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5000 BAPTIST HEALTH DR.
Provider Second Line Business Practice Location Address:
#102
Provider Business Practice Location Address City Name:
SCHERTZ
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78154
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-568-0511
Provider Business Practice Location Address Fax Number:
210-568-0513
Provider Enumeration Date:
10/16/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  1042513 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)