| South Texas Healthcare Inc | |
|
21902 Franklin Park Apt 1308 San Antonio TX 78259-2193 | |
| (210) 491-1690 | |
| (210) 491-1801 |
| Full Name | South Texas Healthcare Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 21902 Franklin Park Apt 1308, San Antonio, Texas |
| Authorized Official Name and Position | Jibrail Kasperkhan (OWNER) |
| Authorized Official Contact | 2104911690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Texas Healthcare Inc 1150 N Loop 1604 W Suite 108-629 San Antonio TX 78248-4503 Ph: (210) 682-0140 | South Texas Healthcare Inc 21902 Franklin Park Apt 1308 San Antonio TX 78259-2193 Ph: (210) 491-1690 |
| NPI Number | 1700276573 |
|---|---|
| Provider Enumeration Date | 01/30/2015 |
| Last Update Date | 07/28/2023 |
| Medicare PECOS PAC ID | 1951620848 |
|---|---|
| Medicare Enrollment ID | O20150427001079 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700276573 | NPI | - | NPPES |
| 1245277300 | Other | TX | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M0453 (Texas) | Primary |
| Provider Name | Jibrail Kasperkhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245277300 PECOS PAC ID: 2264487107 Enrollment ID: I20050314000963 |
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