| |
3202 San Pedro Ave San Antonio TX 78212-2247 | |
(210) 732-5100 | |
(210) 732-5108 |
Full Name | |
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Speciality | Family Medicine |
Location | 3202 San Pedro Ave, San Antonio, Texas |
Authorized Official Name and Position | James M Bromley (OWNER) |
Authorized Official Contact | 2107325100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3202 San Pedro Ave San Antonio TX 78212-2247 Ph: (210) 732-5100 | 3202 San Pedro Ave San Antonio TX 78212-2247 Ph: (210) 732-5100 |
NPI Number | 1316276264 |
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Provider Enumeration Date | 12/23/2009 |
Last Update Date | 07/16/2024 |
Medicare PECOS PAC ID | 3375687973 |
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Medicare Enrollment ID | O20100220000117 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316276264 | NPI | - | NPPES |
104196404 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | H9604 (Texas) | Primary |
Provider Name | James Bromley |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1255336996 PECOS PAC ID: 7113061714 Enrollment ID: I20100220000108 |
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