Provider Demographics
NPI:1124441712
Name:ARGUMEDO, VICTOR (PT, MPT, MCMT, CKTP)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:ARGUMEDO
Suffix:
Gender:M
Credentials:PT, MPT, MCMT, CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6235 STABLE TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4629
Mailing Address - Country:US
Mailing Address - Phone:210-393-0563
Mailing Address - Fax:
Practice Address - Street 1:3453 IH 35 N STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78219-2337
Practice Address - Country:US
Practice Address - Phone:210-293-3111
Practice Address - Fax:210-293-2110
Is Sole Proprietor?:No
Enumeration Date:2014-02-02
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1182589225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist