| Gastroenterology Clinic Of San Antonio, P.a. | |
|
8550 Datapoint Dr Suite 200 San Antonio TX 78229-3270 | |
| (210) 615-8308 | |
| (210) 615-8313 |
| Full Name | Gastroenterology Clinic Of San Antonio, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 8550 Datapoint Dr, San Antonio, Texas |
| Authorized Official Name and Position | Russell Havranek (CEO) |
| Authorized Official Contact | 2106158308 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gastroenterology Clinic Of San Antonio, P.a. 8550 Datapoint Dr Suite 200 San Antonio TX 78229-3270 Ph: (210) 615-8308 | Gastroenterology Clinic Of San Antonio, P.a. 8550 Datapoint Dr Suite 200 San Antonio TX 78229-3270 Ph: (210) 615-8308 |
| NPI Number | 1053490631 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 10/29/2015 |
| Medicare PECOS PAC ID | 7618881681 |
|---|---|
| Medicare Enrollment ID | O20031113000804 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053490631 | NPI | - | NPPES |
| 044080201 | Medicaid | TX | |
| 00BL45 | Other | TX | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Bassem Mazloum |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154374742 PECOS PAC ID: 7517940257 Enrollment ID: I20040611001197 |
| Provider Name | Russell Havranek |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871672519 PECOS PAC ID: 2567417025 Enrollment ID: I20050317000263 |
| Provider Name | Jorge Munoz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164535191 PECOS PAC ID: 3375586100 Enrollment ID: I20050602001031 |
| Provider Name | Gary S Gossen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124091079 PECOS PAC ID: 3274566252 Enrollment ID: I20091211000582 |
| Provider Name | Victor F Zurita |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245319995 PECOS PAC ID: 7810938065 Enrollment ID: I20120125000682 |
| Provider Name | Charles W Randall |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295814952 PECOS PAC ID: 6406760479 Enrollment ID: I20120515000326 |
| Provider Name | Corine Necole Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871963728 PECOS PAC ID: 4183925035 Enrollment ID: I20151217001227 |
| Provider Name | Nicholas P Martinez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174843726 PECOS PAC ID: 0345535688 Enrollment ID: I20160825000268 |
| Provider Name | John Austin Vizuete |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477812121 PECOS PAC ID: 6507156304 Enrollment ID: I20161228001144 |
| Provider Name | Allison Sirakos |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871940650 PECOS PAC ID: 6800187618 Enrollment ID: I20220531001349 |
| Provider Name | Kelly L Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063991800 PECOS PAC ID: 3072971449 Enrollment ID: I20230615003209 |
| Provider Name | Deanna J May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093271546 PECOS PAC ID: 2567820954 Enrollment ID: I20230616000372 |
Texas Bariatric Specialist Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8038 Wurzbach Rd # 650b, San Antonio, TX 78229 Phone: 713-464-7555 Fax: 713-464-0219 | |
Doctor At Your Service Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4242 Medical Dr, Suite 6250, San Antonio, TX 78229 Phone: 210-479-3297 Fax: 210-479-3295 | |
Alexis Wiesenthal Md Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8038 Wurzbach Rd Ste 320, San Antonio, TX 78229 Phone: 210-614-3365 | |
R Family Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3110 Nogalitos, Suite 105, San Antonio, TX 78225 Phone: 210-533-0257 Fax: 210-531-9488 | |
Communicare Health Centers Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 Brooklyn Ave Ste 300, San Antonio, TX 78212 Phone: 210-225-5930 Fax: 210-476-0246 | |
Insulin Rounds P A Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12951 Huebner Rd, #780355, San Antonio, TX 78278 Phone: 210-862-5506 | |
Omni Vision Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9218 Potranco Rd, Suite 105, San Antonio, TX 78251 Phone: 832-331-9831 Fax: 210-855-8365 |