| |
150 E Sonterra Blvd Suite 170 San Antonio TX 78258-4098 | |
(210) 481-2800 | |
(210) 481-2834 |
Full Name | |
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Speciality | Internal Medicine |
Location | 150 E Sonterra Blvd, San Antonio, Texas |
Authorized Official Name and Position | Robert A Zajac (PRESIDENT) |
Authorized Official Contact | 2105586288 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1346 San Antonio TX 78295-1346 Ph: (210) 558-6288 | 150 E Sonterra Blvd Suite 170 San Antonio TX 78258-4098 Ph: (210) 481-2800 |
NPI Number | 1255357653 |
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Provider Enumeration Date | 07/15/2006 |
Last Update Date | 09/15/2015 |
Medicare PECOS PAC ID | 6204831498 |
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Medicare Enrollment ID | O20060921000404 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255357653 | NPI | - | NPPES |
183550601 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | H3973 (Texas) | Primary |
Provider Name | Robert A Zajac |
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Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1013907963 PECOS PAC ID: 6103829726 Enrollment ID: I20060821000053 |
Provider Name | Jose A Ramos |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114233152 PECOS PAC ID: 4486822855 Enrollment ID: I20110729000646 |
Provider Name | Abel Mendez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366896888 PECOS PAC ID: 5092002626 Enrollment ID: I20160927000176 |
Provider Name | Jessica Elaine Drane |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912443193 PECOS PAC ID: 1850674573 Enrollment ID: I20170203000463 |
Provider Name | Traceen Driskill |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730720996 PECOS PAC ID: 6305271644 Enrollment ID: I20200115001416 |
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