| Centromed La Paloma De Paz | |
|
7404 W Us Highway 90 Bldg. 37 San Antonio TX 78227-4024 | |
| (210) 733-8810 | |
| (210) 674-2877 |
| Full Name | Centromed La Paloma De Paz |
|---|---|
| Speciality | Clinic/Center |
| Location | 7404 W Us Highway 90, San Antonio, Texas |
| Authorized Official Name and Position | Chuck Walzel (CFO) |
| Authorized Official Contact | 2103343724 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centromed La Paloma De Paz 3750 Commercial Ave San Antonio TX 78221-3117 Ph: (210) 334-3700 | Centromed La Paloma De Paz 7404 W Us Highway 90 Bldg. 37 San Antonio TX 78227-4024 Ph: (210) 733-8810 |
| NPI Number | 1649343211 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 05/09/2013 |
| Medicare PECOS PAC ID | 6800881285 |
|---|---|
| Medicare Enrollment ID | O20050304000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649343211 | NPI | - | NPPES |
| 120980103 | Medicaid | TX | |
| 120980101 | Medicaid | TX | |
| 120980102 | Medicaid | TX | |
| 00MT08 | Other | TX | GROUP MEDICARE |
| 120980105 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | HBOCS007758-04-00 (Texas) | Primary |
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