MEDICARE: AAA MEDICAL SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	174400000X	Specialist
3	207L00000X	Anesthesiology Physician
4	261QP2000X	Physical Therapy Clinic/Center
5	261QP3300X	Pain Clinic/Center
6	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1639472251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAA MEDICAL SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	6127 SAN PEDRO STE 2
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7204
Country	:	US
Telephone Number	:	210-495-0086
Fax Number	:	210-495-0801

Provider Business Practice Location Address
First Line	:	6127 SAN PEDRO STE 2
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7204
Country	:	US
Telephone Number	:	210-495-0086
Fax Number	:	210-495-0801

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MR. EDWARD ANTHONY DESTEFANO
Credential	:
Telephone Number	:	210-495-0086

Provider Enumeration Date	:	12/21/2010
Last Update Date	:	12/21/2010

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Directions to “AAA MEDICAL SOLUTIONS LLC ” Practice Location

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