| |
4435 Dezavala San Antonio TX 78249-2040 | |
(210) 694-4081 | |
(210) 696-8053 |
Full Name | |
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Speciality | Family Medicine |
Location | 4435 Dezavala, San Antonio, Texas |
Authorized Official Name and Position | Sara Jane Apsley Ambriz (OWNER) |
Authorized Official Contact | 2106944081 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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4435 Dezavala San Antonio TX 78249-2040 Ph: (210) 694-4081 | 4435 Dezavala San Antonio TX 78249-2040 Ph: (210) 694-4081 |
NPI Number | 1487971867 |
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Provider Enumeration Date | 04/26/2010 |
Last Update Date | 04/15/2011 |
Medicare PECOS PAC ID | 4385778588 |
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Medicare Enrollment ID | O20100810000358 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487971867 | NPI | - | NPPES |
2158131-01 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | G4792 (Texas) | Primary |
Provider Name | Steven C Mays |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1376556811 PECOS PAC ID: 5698793669 Enrollment ID: I20051108000720 |
Provider Name | Sara J Apsley- Ambriz |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942205919 PECOS PAC ID: 6800828542 Enrollment ID: I20070322000495 |
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