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2303 Se Military Dr San Antonio TX 78223-3542 | |
(210) 531-7809 | |
(210) 531-7796 |
Full Name | |
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Speciality | Clinic/center |
Location | 2303 Se Military Dr, San Antonio, Texas |
Authorized Official Name and Position | Hector C Baltierra (TEAM LEAD) |
Authorized Official Contact | 5122065011 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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4110 Guadalupe St Hospital Revenue Mgmt-mc2028 Austin TX 78751-4223 Ph: (512) 206-5011 | 2303 Se Military Dr San Antonio TX 78223-3542 Ph: (210) 531-7809 |
NPI Number | 1316000144 |
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Provider Enumeration Date | 12/19/2006 |
Last Update Date | 08/09/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316000144 | NPI | - | NPPES |
1332579-04 | Medicaid | TX | |
HH4568 | Other | TX | BCBS |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (Texas) | Primary |
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