Provider Demographics
NPI:1285477109
Name:COBOS, FERNANDO AARON JR (PTA)
Entity type:Individual
Prefix:
First Name:FERNANDO
Middle Name:AARON
Last Name:COBOS
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 781372
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-1372
Mailing Address - Country:US
Mailing Address - Phone:361-453-9505
Mailing Address - Fax:
Practice Address - Street 1:138 OLD SAN ANTONIO RD STE 304
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3491
Practice Address - Country:US
Practice Address - Phone:210-419-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2180694225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant