Healthcare Provider's Profile
Full Name | |
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Type | Facility |
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Speciality | Physical Medicine & Rehabilitation - Pain Medicine |
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Location | 9910 Huebner Rd Ste 140, San Antonio, Texas |
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Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1245760263
- Provider Enumeration Date: 06/13/2017
- Last Update Date: 07/21/2022
Medical Identifiers
Medical identifiers for
such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1245760263 | NPI | - | NPPES |
582702 | Other | TX | MEDICARE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
207L00000X | Anesthesiology | (* (Not Available)) | Secondary |
2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | (* (Not Available)) | Primary |
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
9910 Huebner Rd Ste 140, San Antonio, TX 78240-1342 Ph: (210) 697-9700 | 9910 Huebner Rd Ste 140, San Antonio, TX 78240-1342 Ph: (210) 697-9700 |
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