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19100 Ridgewood Pkwy San Antonio TX 78259-1828 | |
(210) 626-4892 | |
(210) 626-4898 |
Full Name | |
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Speciality | Clinic/center |
Location | 19100 Ridgewood Pkwy, San Antonio, Texas |
Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
Authorized Official Contact | 2164799063 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5500 Maryland Way Brentwood TN 37027-4948 Ph: (888) 830-4255 | 19100 Ridgewood Pkwy San Antonio TX 78259-1828 Ph: (210) 626-4892 |
NPI Number | 1730317553 |
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Provider Enumeration Date | 07/01/2009 |
Last Update Date | 08/23/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730317553 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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