| Greater Sa House Calls, Llc | |
|
5309 Wurzbach Rd Ste 106 San Antonio TX 78238-2431 | |
| (210) 647-4671 | |
| (210) 647-7552 |
| Full Name | Greater Sa House Calls, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 5309 Wurzbach Rd Ste 106, San Antonio, Texas |
| Authorized Official Name and Position | Ughanmwan Tokunbor Efeovbokhan (OWNER) |
| Authorized Official Contact | 2107891274 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Sa House Calls, Llc 9531 Autumn Breeze San Antonio TX 78254-1969 Ph: (210) 647-4671 | Greater Sa House Calls, Llc 5309 Wurzbach Rd Ste 106 San Antonio TX 78238-2431 Ph: (210) 647-4671 |
| NPI Number | 1669701959 |
|---|---|
| Provider Enumeration Date | 12/15/2009 |
| Last Update Date | 03/22/2022 |
| Medicare PECOS PAC ID | 9739219031 |
|---|---|
| Medicare Enrollment ID | O20100614000172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669701959 | NPI | - | NPPES |
| Provider Name | Ughanmwan T Efeovbokhan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649387630 PECOS PAC ID: 7113992611 Enrollment ID: I20040828000071 |
| Provider Name | Justo L Cisneros |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427168061 PECOS PAC ID: 3173541760 Enrollment ID: I20051102000529 |
| Provider Name | Kasey A Frye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609058908 PECOS PAC ID: 5294796512 Enrollment ID: I20150608000998 |
| Provider Name | Elizabeth Jo Sparkman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548645047 PECOS PAC ID: 9234421041 Enrollment ID: I20160714000277 |
| Provider Name | Juliet Makena Gatobu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245711050 PECOS PAC ID: 2769728765 Enrollment ID: I20220126000320 |
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