Individual ProviderVictor Manuel QuevedoOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4207 Gardendale St Ste 104b, San Antonio, TX 78229-3142(210) 582-5840PECOS EnrollmentBased on the most recent information from CMS, provider Victor Manuel Quevedo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1518599083Provider TypeIndividualFull NameQuevedo, Victor ManuelCredentialOTGenderMaleSole ProprietorNoEnumeration Date2/12/2020Last Updated2/12/2020Contact InformationPractice LocationPractice Address4207 Gardendale St Ste 104b, San Antonio, TX 78229-3142Phone(210) 582-5840FaxUnlisted FaxMailing LocationMailing Address4207 Gardendale St Ste 104b, San Antonio, TX 78229-3142PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225X00000XPrimaryDescriptionOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense120417Texas