| Boldly Go, Inc. | |
|
166 Babcock Rd San Antonio TX 78201-3806 | |
| (210) 834-3534 | |
| Not Available |
| Full Name | Boldly Go, Inc. |
|---|---|
| Speciality | Counselor - Professional |
| Location | 166 Babcock Rd, San Antonio, Texas |
| Authorized Official Name and Position | Yvonne Pozos Garcia (DIRECTOR) |
| Authorized Official Contact | 2108343534 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Boldly Go, Inc. 166 Babcock Rd San Antonio TX 78201-3806 Ph: (210) 834-3534 | Boldly Go, Inc. 166 Babcock Rd San Antonio TX 78201-3806 Ph: (210) 834-3534 |
| NPI Number | 1417435132 |
|---|---|
| Provider Enumeration Date | 08/03/2018 |
| Last Update Date | 08/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417435132 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 71100 (Texas) | Primary |
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