| San Marcos Diagnostics Pa | |
|
1305 Wonder World Dr Ste 206 San Marcos TX 78666-7540 | |
| (512) 396-1525 | |
| Not Available |
| Full Name | San Marcos Diagnostics Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1305 Wonder World Dr Ste 206, San Marcos, Texas |
| Authorized Official Name and Position | Grayson Keith Smith (PRESIDENT) |
| Authorized Official Contact | 5123961525 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Marcos Diagnostics Pa 1305 Wonder World Dr Ste 206 San Marcos TX 78666-7540 Ph: () - | San Marcos Diagnostics Pa 1305 Wonder World Dr Ste 206 San Marcos TX 78666-7540 Ph: (512) 396-1525 |
| NPI Number | 1235327073 |
|---|---|
| Provider Enumeration Date | 10/05/2007 |
| Last Update Date | 11/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235327073 | NPI | - | NPPES |
| 0032MD | Other | TX | BCBS |
| 170927101 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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