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3327 Research Plz Ste 307 San Antonio TX 78235-5158 | |
(210) 223-3543 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 3327 Research Plz Ste 307, San Antonio, Texas |
Authorized Official Name and Position | Lawrence C Walzel (VP/CFO) |
Authorized Official Contact | 2103343724 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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3750 Commercial Ave San Antonio TX 78221-3117 Ph: (210) 922-7000 | 3327 Research Plz Ste 307 San Antonio TX 78235-5158 Ph: (210) 223-3543 |
NPI Number | 1548908080 |
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Provider Enumeration Date | 05/24/2022 |
Last Update Date | 06/01/2022 |
Medicare PECOS PAC ID | 6800881285 |
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Medicare Enrollment ID | O20220714003857 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548908080 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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