Healthcare Provider Details

I. General information

NPI: 1437123791
Provider Name (Legal Business Name): METROPOLITAN FAMILY PRACTICE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 MCCULLOUGH AVE STE 135
SAN ANTONIO TX
78212
US

IV. Provider business mailing address

1303 MCCULLOUGH AVE STE 135
SAN ANTONIO TX
78212-5609
US

V. Phone/Fax

Practice location:
  • Phone: 210-227-9214
  • Fax: 210-476-8515
Mailing address:
  • Phone: 210-227-9214
  • Fax: 210-476-8515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTINE A MONTGOMERY
Title or Position: ADMINISTRATOR
Credential:
Phone: 210-227-9214