Healthcare Provider Details

I. General information

NPI: 1114365681
Provider Name (Legal Business Name): PULMONOLOGY AND SLEEP SERVICES OF SAN ANTONIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

11901 TOEPPERWEIN RD STE 1401
LIVE OAK TX
78233-3161
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 Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD TALIB
Title or Position: GENERAL MANAGER
Credential:
Phone: 210-599-1433