| Stone Oak Urgent Care/ Family Practice | |
|
104 Gallery Cir Ste 114 San Antonio TX 78258-3330 | |
| (210) 481-6060 | |
| (210) 481-6068 |
| Full Name | Stone Oak Urgent Care/ Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 104 Gallery Cir Ste 114, San Antonio, Texas |
| Authorized Official Name and Position | Sudhir R Gogu (PHYSICIAN) |
| Authorized Official Contact | 2104816060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stone Oak Urgent Care/ Family Practice 104 Gallery Cir Ste 114 San Antonio TX 78258-3330 Ph: (210) 481-6060 | Stone Oak Urgent Care/ Family Practice 104 Gallery Cir Ste 114 San Antonio TX 78258-3330 Ph: (210) 481-6060 |
| NPI Number | 1194908285 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 06/17/2024 |
| Medicare PECOS PAC ID | 2769566652 |
|---|---|
| Medicare Enrollment ID | O20080303000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194908285 | NPI | - | NPPES |
| 1194908285 | Medicaid | TX | |
| H19945 | Other | TX | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L0209 (Texas) | Primary |
| Provider Name | Sudhir R Gogu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942270400 PECOS PAC ID: 5991791980 Enrollment ID: I20040423001104 |
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