Provider Demographics
NPI:1699351973
Name:WARD, ANDREA SARAI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:SARAI
Last Name:WARD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10415 STATE HIGHWAY 151 STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4553
Mailing Address - Country:US
Mailing Address - Phone:210-647-9970
Mailing Address - Fax:
Practice Address - Street 1:15614 HUEBNER RD STE 115
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-0993
Practice Address - Country:US
Practice Address - Phone:210-479-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
TX1342327208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1342327OtherPROFESSIONAL LICENSE