| Centromed Sa Pediatrics | |
|
9793 Culebra Rd Ste 105 San Antonio TX 78251-3750 | |
| (210) 223-3543 | |
| (210) 924-1374 |
| Full Name | Centromed Sa Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 9793 Culebra Rd Ste 105, San Antonio, Texas |
| Authorized Official Name and Position | Lawrence C Walzel (VP/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 Sa Pediatrics 3750 Commercial Ave San Antonio TX 78221-3117 Ph: (210) 922-7000 | Centromed Sa Pediatrics 9793 Culebra Rd Ste 105 San Antonio TX 78251-3750 Ph: (210) 223-3543 |
| NPI Number | 1699320614 |
|---|---|
| Provider Enumeration Date | 08/06/2019 |
| Last Update Date | 06/01/2022 |
| Medicare PECOS PAC ID | 6800881285 |
|---|---|
| Medicare Enrollment ID | O20191016001165 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699320614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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