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NPI Code Detail

MEDICARE: CFSA PLLC

MEDICARE: CFSA PLLC
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
1122300000XDentist25764TX
2335E00000XProsthetic/Orthotic Supplier25764TX

General Provider Information

NPI Number : 1487058442
Entity Type Code : Organization
Provider Name (Legal Business Name) : CFSA PLLC
Provider Business Mailing Address
First Line : 8700 MARBACH RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78227-2345
Country : US
Telephone Number : 210-675-7000
Fax Number :
Provider Business Practice Location Address
First Line : 8700 MARBACH RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78227-2345
Country : US
Telephone Number : 210-675-7000
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : DR. BRADLEY SMITH
Credential : DDS
Telephone Number : 210-675-7000
Provider Enumeration Date : 10/20/2014
Last Update Date : 10/20/2014

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