Aspire Regenerative Wound Care Corp | |
1901 Nw Military Hwy Ste 222 San Antonio TX 78213-2149 | |
(210) 977-0070 | |
(210) 977-0220 |
Full Name | Aspire Regenerative Wound Care Corp |
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Speciality | General Practice |
Location | 1901 Nw Military Hwy Ste 222, San Antonio, Texas |
Authorized Official Name and Position | Ki E Kroll (OWNER) |
Authorized Official Contact | 2109770070 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Aspire Regenerative Wound Care Corp 1901 Nw Military Hwy Ste 222 San Antonio TX 78213-2149 Ph: (210) 977-0070 | Aspire Regenerative Wound Care Corp 1901 Nw Military Hwy Ste 222 San Antonio TX 78213-2149 Ph: (210) 977-0070 |
NPI Number | 1750145454 |
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Provider Enumeration Date | 02/13/2024 |
Last Update Date | 03/30/2024 |
Medicare PECOS PAC ID | 9537602180 |
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Medicare Enrollment ID | O20240624003165 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750145454 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Trenice Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1033522461 PECOS PAC ID: 4688999196 Enrollment ID: I20150204000764 |
Provider Name | Kingsley George Iheme |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396370003 PECOS PAC ID: 4082782990 Enrollment ID: I20200430002341 |
Provider Name | Lauri Beechler |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457991119 PECOS PAC ID: 3476967837 Enrollment ID: I20210126000714 |
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