| Texas Association Of Pediatric Neurology, Pa | |
|
525 Oak Centre Dr Suite #400 San Antonio TX 78258-3944 | |
| (210) 615-2333 | |
| (210) 490-5024 |
| Full Name | Texas Association Of Pediatric Neurology, Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Neuromuscular Medicine |
| Location | 525 Oak Centre Dr, San Antonio, Texas |
| Authorized Official Name and Position | Jerry J Tomasovic (OWNER) |
| Authorized Official Contact | 2106152333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Association Of Pediatric Neurology, Pa Po Box 34713 San Antonio TX 78265-4713 Ph: (210) 615-2333 | Texas Association Of Pediatric Neurology, Pa 525 Oak Centre Dr Suite #400 San Antonio TX 78258-3944 Ph: (210) 615-2333 |
| NPI Number | 1124246103 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 07/29/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124246103 | NPI | - | NPPES |
| 095077602 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0008X | Psychiatry & Neurology - Neuromuscular Medicine | G7730 (Texas) | Primary |
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