Healthcare Provider Details

I. General information

NPI: 1639251838
Provider Name (Legal Business Name): BEXAR COUNTY MANAGEMENT CO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 02/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 W HOUSTON ST SUITE 909
SAN ANTONIO TX
78205-2107
US

IV. Provider business mailing address

1842 LOCKHILL SELMA RD SUITE 101
SAN ANTONIO TX
78213-1559
US

V. Phone/Fax

Practice location:
  • Phone: 210-222-0376
  • Fax:
Mailing address:
  • Phone: 210-348-7654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOE L GOMEZ
Title or Position: CEO
Credential:
Phone: 210-348-7654