| San Antonio Neurohospitalist Organization | |
|
12412 Judson Rd Live Oak TX 78233-3255 | |
| (210) 331-7266 | |
| Not Available |
| Full Name | San Antonio Neurohospitalist Organization |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 12412 Judson Rd, Live Oak, Texas |
| Authorized Official Name and Position | Allen Garcia (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 2104455079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| San Antonio Neurohospitalist Organization 11703 Huebner Rd Ste 106-402 San Antonio TX 78230-1201 Ph: (210) 331-7266 | San Antonio Neurohospitalist Organization 12412 Judson Rd Live Oak TX 78233-3255 Ph: (210) 331-7266 |
| NPI Number | 1619458403 |
|---|---|
| Provider Enumeration Date | 08/28/2018 |
| Last Update Date | 09/21/2023 |
| Certification Date | 09/21/2023 |
| Medicare PECOS PAC ID | 9638422215 |
|---|---|
| Medicare Enrollment ID | O20181029001849 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619458403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Ann Doan-do Bass |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104925171 PECOS PAC ID: 7113067166 Enrollment ID: I20100628000829 |
| Provider Name | Bob A Silva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093819302 PECOS PAC ID: 2860687134 Enrollment ID: I20101111001340 |
| Provider Name | Jeffrey Theodore Harris |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639165749 PECOS PAC ID: 5799791943 Enrollment ID: I20110104001231 |
| Provider Name | Gregory J Brogden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659674760 PECOS PAC ID: 7719156405 Enrollment ID: I20110815000635 |
| Provider Name | Bobbi Jo Bridges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013314459 PECOS PAC ID: 8628399839 Enrollment ID: I20150529002400 |
| Provider Name | Jessica Andrea Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588204077 PECOS PAC ID: 2466714845 Enrollment ID: I20200304002439 |
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