Healthcare Provider Details

I. General information

NPI: 1023183027
Provider Name (Legal Business Name): PULMONOLOGY & SLEEP SERVICES OF SAN ANTONIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11901 TOEPPERWEIN RD SUITE 1401
LIVE OAK TX
78233-3161
US

IV. Provider business mailing address

PO BOX 840439
DALLAS TX
75284-0439
US

V. Phone/Fax

Practice location:
  • Phone: 210-599-1433
  • Fax: 210-599-1803
Mailing address:
  • Phone: 210-599-1433
  • Fax: 210-599-1803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberM0533
License Number StateTX

VIII. Authorized Official

Name: MOHAMMED A. QURESHI
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 210-599-1433