| St. Lazarus Family Practice P.a. | |
|
14345 Blanco Rd San Antonio TX 78216-7723 | |
| (210) 802-7003 | |
| (210) 519-2970 |
| Full Name | St. Lazarus Family Practice P.a. |
|---|---|
| Speciality | General Practice |
| Location | 14345 Blanco Rd, San Antonio, Texas |
| Authorized Official Name and Position | Christine A. Contreras (PRESIDENT) |
| Authorized Official Contact | 2108027003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Lazarus Family Practice P.a. 14345 Blanco Rd San Antonio TX 78216-7723 Ph: (210) 802-7003 | St. Lazarus Family Practice P.a. 14345 Blanco Rd San Antonio TX 78216-7723 Ph: (210) 802-7003 |
| NPI Number | 1598210411 |
|---|---|
| Provider Enumeration Date | 08/20/2016 |
| Last Update Date | 07/14/2023 |
| Medicare PECOS PAC ID | 1456632058 |
|---|---|
| Medicare Enrollment ID | O20161219001644 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598210411 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | N8176 (Texas) | Primary |
| Provider Name | Christine A Contreras |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619133238 PECOS PAC ID: 7113174277 Enrollment ID: I20120823000831 |
| Provider Name | Tracey Cawthorn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982850665 PECOS PAC ID: 1658516588 Enrollment ID: I20130326000248 |
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