Provider Demographics
NPI:1023051570
Name:BIASIOLLI, JAMES ANTHONY
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:BIASIOLLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CONCORD PLAZA DR
Mailing Address - Street 2:130
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6905
Mailing Address - Country:US
Mailing Address - Phone:210-804-5536
Mailing Address - Fax:210-804-5538
Practice Address - Street 1:400 CONCORD PLAZA DR
Practice Address - Street 2:130
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6905
Practice Address - Country:US
Practice Address - Phone:210-804-5536
Practice Address - Fax:210-804-5538
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109037225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7480746OtherAETNA
TX8T4547OtherBCBS
TXQ53236Medicare UPIN
TX7480746OtherAETNA