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5788 Eckhert Rd. San Antonio TX 78240 | |
| (210) 699-2158 | |
| (210) 699-2257 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 5788 Eckhert Rd., San Antonio, Texas |
| Authorized Official Name and Position | Tim Shea (DIRECTOR) |
| Authorized Official Contact | 2106175300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5788 Eckhert Rd San Antonio TX 78240-3900 Ph: (210) 699-2158 | 5788 Eckhert Rd. San Antonio TX 78240 Ph: (210) 699-2158 |
| NPI Number | 1124121462 |
|---|---|
| Provider Enumeration Date | 09/05/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124121462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | SO3648 (Texas) | Primary |
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