Provider Demographics
NPI:1144654369
Name:TAMAREN, SAUL (LMT)
Entity type:Individual
Prefix:
First Name:SAUL
Middle Name:
Last Name:TAMAREN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14902 ENCHANTED CASTLE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3052
Mailing Address - Country:US
Mailing Address - Phone:210-849-5545
Mailing Address - Fax:
Practice Address - Street 1:14902 ENCHANTED CASTLE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-3052
Practice Address - Country:US
Practice Address - Phone:210-849-5545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT014649225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist