| |
1419 Austin Hwy San Antonio TX 78209-4337 | |
(210) 262-6413 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 1419 Austin Hwy, San Antonio, Texas |
Authorized Official Name and Position | Fnu Rajlakshmi (OWNER) |
Authorized Official Contact | 2102626413 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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128 Auburn Pl San Antonio TX 78209-4722 Ph: (210) 262-6413 | 1419 Austin Hwy San Antonio TX 78209-4337 Ph: (210) 262-6413 |
NPI Number | 1487247284 |
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Provider Enumeration Date | 02/12/2021 |
Last Update Date | 06/08/2021 |
Medicare PECOS PAC ID | 1355757204 |
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Medicare Enrollment ID | O20210302000069 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487247284 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
208600000X | Surgery | (* (Not Available)) | Secondary |
Provider Name | Fnu Rajlakshmi |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1588951586 PECOS PAC ID: 4284855107 Enrollment ID: I20141017001814 |
Provider Name | Ashwini Kumar |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1215184841 PECOS PAC ID: 6103131214 Enrollment ID: I20150819007321 |
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