MEDICARE: SOUTH TEXAS LICE CLINICS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

General Provider Information

NPI Number	:	1346740743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH TEXAS LICE CLINICS LLC

Provider Business Mailing Address
First Line	:	6391 DE ZAVALA RD STE 222
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2159
Country	:	US
Telephone Number	:	210-409-4635
Fax Number	:

Provider Business Practice Location Address
First Line	:	6391 DE ZAVALA RD STE 222
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2159
Country	:	US
Telephone Number	:	210-409-4635
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TRACY COPELAND
Credential	:
Telephone Number	:	210-409-4635

Provider Enumeration Date	:	02/13/2018
Last Update Date	:	02/13/2018

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1104974773 — DR. RICHARD PAUL YURCHESHEN PH.D.
Practice Location Address:

6391 DE ZAVALA RD STE 203C
SAN ANTONIO, TX
78249-2159

Practice Phone: 210-734-6668
Practice Fax: 210-734-6660

1932612058 — SOUTH TEXAS HEALTH & WELLNESS, LLC
Practice Location Address:

6391 DE ZAVALA RD STE 300
SAN ANTONIO, TX
78249-2159

Practice Phone: 405-761-3419
Practice Fax:

1750385027 — LETISHA ANNETTE SNEED M.D.
Practice Location Address:

21759 LUISA
SAN ANTONIO, TX
78259-2159

Practice Phone: 210-481-2544
Practice Fax:

1881674471 — DR. RAUL ANDRES GARCA D.D.S.
Practice Location Address:

12750 CARMEL COUNTRY RD , SUITE 209
SAN DIEGO, CA
92130-2159

Practice Phone: 858-755-7805
Practice Fax:

1932152816 — DR. BARBARA BYTOMSKI O.D.
Practice Location Address:

9320 CARMEL MOUNTAIN RD , STE E
SAN DIEGO, CA
92129-2159

Practice Phone: 858-484-1500
Practice Fax: 858-484-8416

Directions to “SOUTH TEXAS LICE CLINICS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.