| Garza Medical Group -south Alamo | |
|
5414 Fredericksburg Rd Ste 265 San Antonio TX 78229-3641 | |
| (210) 256-1539 | |
| (210) 549-0039 |
| Full Name | Garza Medical Group -south Alamo |
|---|---|
| Speciality | Family Medicine |
| Location | 5414 Fredericksburg Rd Ste 265, San Antonio, Texas |
| Authorized Official Name and Position | Nelson Bocanegra (PRACTICE MANAGER) |
| Authorized Official Contact | 2102561539 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garza Medical Group -south Alamo 5414 Fredericksburg Rd Ste 265 San Antonio TX 78229-3641 Ph: (210) 256-1539 | Garza Medical Group -south Alamo 5414 Fredericksburg Rd Ste 265 San Antonio TX 78229-3641 Ph: (210) 256-1539 |
| NPI Number | 1396231320 |
|---|---|
| Provider Enumeration Date | 07/02/2018 |
| Last Update Date | 09/25/2019 |
| Medicare PECOS PAC ID | 8729322011 |
|---|---|
| Medicare Enrollment ID | O20181127001562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396231320 | NPI | - | NPPES |
| 1972500684 | Other | TX | PPO, HMO AND MARKET-PLACE |
| 1396231320 | Medicaid | TX | |
| 1972500684 | Medicaid | TX | |
| 1396231320 | Other | TX | PPO, HMO AND MARKET PLACE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Nora O Garza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972500684 PECOS PAC ID: 1850362716 Enrollment ID: I20040804000325 |
| Provider Name | Deborah Centeno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396722187 PECOS PAC ID: 3476573080 Enrollment ID: I20051128000797 |
| Provider Name | Robert G Jakubowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780654475 PECOS PAC ID: 3779641139 Enrollment ID: I20081205000368 |
| Provider Name | Susan P Mangum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962657486 PECOS PAC ID: 7214114792 Enrollment ID: I20110609000464 |
| Provider Name | Theresa L Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750619458 PECOS PAC ID: 5698100915 Enrollment ID: I20200115000736 |
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