Community Family Medicine Pa | |
1616 Callaghan Rd San Antonio TX 78228 | |
(210) 435-1218 | |
(210) 435-3162 |
Full Name | Community Family Medicine Pa |
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Speciality | Family Medicine |
Location | 1616 Callaghan Rd, San Antonio, Texas |
Authorized Official Name and Position | Javier C Bocanegra (MD LOWNER) |
Authorized Official Contact | 2104351218 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Family Medicine Pa 1616 Callaghan Rd San Antonio TX 78228 Ph: (210) 435-1218 | Community Family Medicine Pa 1616 Callaghan Rd San Antonio TX 78228 Ph: (210) 435-1218 |
NPI Number | 1295825990 |
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Provider Enumeration Date | 10/13/2006 |
Last Update Date | 07/02/2010 |
Medicare PECOS PAC ID | 8123931011 |
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Medicare Enrollment ID | O20031106000778 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295825990 | NPI | - | NPPES |
121539402 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | H2253 (Texas) | Primary |
Provider Name | Javier Bocanegra |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003837758 PECOS PAC ID: 7911810817 Enrollment ID: I20100803000909 |
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