| Centromed Sarah E. Davidson Clinic | |
|
1 Haven For Hope Way Bldg1 #300 San Antonio TX 78207-1108 | |
| (210) 220-2330 | |
| (210) 220-2332 |
| Full Name | Centromed Sarah E. Davidson Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Haven For Hope Way Bldg1 #300, 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 Sarah E. Davidson Clinic 3750 Commercial Ave San Antonio TX 78221-3117 Ph: (210) 334-3700 | Centromed Sarah E. Davidson Clinic 1 Haven For Hope Way Bldg1 #300 San Antonio TX 78207-1108 Ph: (210) 220-2330 |
| NPI Number | 1841433562 |
|---|---|
| Provider Enumeration Date | 04/10/2009 |
| Last Update Date | 05/09/2012 |
| Medicare PECOS PAC ID | 6800881285 |
|---|---|
| Medicare Enrollment ID | O20091020000246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841433562 | NPI | - | NPPES |
| 120980102 | Medicaid | TX | |
| 00MT08 | Other | TX | GROUP MEDICARE |
| 120980101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | HBOCS007580400 (Texas) | Primary |
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