| Dr Theodore Gill Hart, MD | |
| 
					3551 Roger Brooke Dr, Dept Of Vascular Surgery, Fort Sam Houston, TX 78234  | |
| (210) 916-1174 | |
| Not Available | 
| Full Name | Dr Theodore Gill Hart | 
|---|---|
| Gender | Male | 
| Speciality | Surgery - Vascular Surgery | 
| Location | 3551 Roger Brooke Dr, Fort Sam Houston, Texas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1679987671 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208600000X | Surgery | T3098 (Texas) | Secondary | 
| 2086S0129X | Surgery - Vascular Surgery | T3098 (Texas) | Primary | 
| Entity Name | The University Of Texas Health Science Center At San Antonio | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1720051717 PECOS PAC ID: 0042128548 Enrollment ID: O20040607000664  | 
| Entity Name | San Antonio Vascular And Endovascular Clinic Pllc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1578085791 PECOS PAC ID: 7911263744 Enrollment ID: O20171113000576  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Theodore Gill Hart, MD 3551 Roger Brooke Dr, Dept Of Vascular Surgery, Fort Sam Houston, TX 78234 Ph: (210) 916-1174  | Dr Theodore Gill Hart, MD 3551 Roger Brooke Dr, Dept Of Vascular Surgery, Fort Sam Houston, TX 78234 Ph: (210) 916-1174  | 
Dr. George Earl Peoples Jr., M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3851 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-916-4235 Fax: 210-916-5102  | |
Dr. Jeremy Tyler Bolin, MD Surgery Medicare: Medicare Enrolled Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-539-9582  | |
Penelope Anne Herder, DO Surgery Medicare: Medicare Enrolled Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-539-9582  | |
Dr. Tommy Alan Brown Ii, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-916-3400  | |
Dr. Pamela Christine Masella, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234 Phone: 210-916-0393  | |
Dr. Bradley A Rittenhouse, MD Surgery Medicare: Medicare Enrolled Practice Location: Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234 Phone: 210-539-9582  | |
Justin Jay Sleeter, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 3551 Roger Brooke Dr, Jbsa, Fort Sam Houston, TX 78234 Phone: 210-916-0439  |