Provider Demographics
NPI:1063913598
Name:WATSON, MARIA THERESA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:THERESA
Last Name:WATSON
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 1:7803 S NEW BRAUNFELS APT 9203
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235-1051
Mailing Address - Country:US
Mailing Address - Phone:210-663-5206
Mailing Address - Fax:
Practice Address - Street 1:7803 S NEW BRAUNFELS APT 9203
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-1051
Practice Address - Country:US
Practice Address - Phone:210-663-5206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214829164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse