| Tandi Medical Center Pa | |
|
10607 Liberty Field Suite 103 San Antonio TX 78254 | |
| (210) 999-5586 | |
| (210) 999-5605 |
| Full Name | Tandi Medical Center Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 10607 Liberty Field, San Antonio, Texas |
| Authorized Official Name and Position | Sandra L Nieto (PRESIDENT) |
| Authorized Official Contact | 2109995586 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tandi Medical Center Pa Po Box 1714 Helotes TX 78023-1714 Ph: (210) 999-5586 | Tandi Medical Center Pa 10607 Liberty Field Suite 103 San Antonio TX 78254 Ph: (210) 999-5586 |
| NPI Number | 1376843177 |
|---|---|
| Provider Enumeration Date | 10/26/2010 |
| Last Update Date | 01/31/2011 |
| Medicare PECOS PAC ID | 0143293589 |
|---|---|
| Medicare Enrollment ID | O20040814000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376843177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K4173 (Texas) | Primary |
| Provider Name | Sandra L Nieto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467580191 PECOS PAC ID: 6406829845 Enrollment ID: I20071204000840 |
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