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255 E Sonterra Blvd Ste 100 San Antonio TX 78258-4076 | |
| (210) 404-0000 | |
| (210) 404-2813 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 255 E Sonterra Blvd Ste 100, San Antonio, Texas |
| Authorized Official Name and Position | Roberta S. Cloud (VICE PRESIDENT) |
| Authorized Official Contact | 2105758505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
255 E Sonterra Blvd Ste 100 San Antonio TX 78258-4076 Ph: (210) 404-0000 | 255 E Sonterra Blvd Ste 100 San Antonio TX 78258-4076 Ph: (210) 404-0000 |
| NPI Number | 1568619005 |
|---|---|
| Provider Enumeration Date | 08/27/2008 |
| Last Update Date | 10/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568619005 | NPI | - | NPPES |
| DO3578 | Other | MEDICARE RR | |
| H00019RT01 | Other | TX | BCBS |
| 197507001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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