| |
14811 San Pedro Ave San Antonio TX 78232-3708 | |
(210) 233-7000 | |
(210) 494-2353 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 14811 San Pedro Ave, San Antonio, Texas |
Authorized Official Name and Position | Hung-vy M Nguyen (CEO) |
Authorized Official Contact | 2102337070 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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3066 E Commerce St San Antonio TX 78220-1013 Ph: (210) 233-7000 | 14811 San Pedro Ave San Antonio TX 78232-3708 Ph: (210) 233-7000 |
NPI Number | 1205201142 |
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Provider Enumeration Date | 12/03/2015 |
Last Update Date | 01/16/2023 |
Identifier | Type | State | Issuer |
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1205201142 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
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