Healthcare Provider Details

I. General information

NPI: 1720028442
Provider Name (Legal Business Name): SAN ANTONIO EXTENDED MEDICAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 SHILOH DR STE C3
LAREDO TX
78045-6755
US

IV. Provider business mailing address

21195 INTERSTATE HIGHWAY 10 WEST SUTIE 1101
SAN ANTONIO TX
78257-1675
US

V. Phone/Fax

Practice location:
  • Phone: 956-753-2211
  • Fax: 956-338-0507
Mailing address:
  • Phone: 210-697-9933
  • Fax: 210-697-8753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number00796980
License Number StateTX

VIII. Authorized Official

Name: CARLOS BARRERA
Title or Position: PRESIDENT
Credential:
Phone: 210-697-9933