| South Texas Specialty Care Pllc | |
|
225 E Sonterra Blvd Ste 101 San Antonio TX 78258-3995 | |
| (210) 550-2877 | |
| (210) 866-4587 |
| Full Name | South Texas Specialty Care Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 225 E Sonterra Blvd Ste 101, San Antonio, Texas |
| Authorized Official Name and Position | Cyril Compton Gaiennie (MEMBER) |
| Authorized Official Contact | 2105502877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Texas Specialty Care Pllc 19236 Reata Trl San Antonio TX 78258-4025 Ph: (210) 550-5531 | South Texas Specialty Care Pllc 225 E Sonterra Blvd Ste 101 San Antonio TX 78258-3995 Ph: (210) 550-2877 |
| NPI Number | 1518787845 |
|---|---|
| Provider Enumeration Date | 10/11/2024 |
| Last Update Date | 10/11/2024 |
| Medicare PECOS PAC ID | 6406384510 |
|---|---|
| Medicare Enrollment ID | O20250116001380 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518787845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Cyril Compton Gaiennie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851890388 PECOS PAC ID: 5092060483 Enrollment ID: I20180627000142 |
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