Provider Demographics
NPI:1366572448
Name:GROTE, ANTONIETTA GUADALUPE (PTA)
Entity type:Individual
Prefix:MRS
First Name:ANTONIETTA
Middle Name:GUADALUPE
Last Name:GROTE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8723 FINLANDIA ROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4964
Mailing Address - Country:US
Mailing Address - Phone:361-249-5686
Mailing Address - Fax:
Practice Address - Street 1:8723 FINLANDIA ROCK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4964
Practice Address - Country:US
Practice Address - Phone:361-249-5686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2056196225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant