Healthcare Provider Details

I. General information

NPI: 1154061703
Provider Name (Legal Business Name): GEBITO MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E AMBER ST STE 107
SAN ANTONIO TX
78221-2403
US

IV. Provider business mailing address

4101 MCINNIS RD
SAN ANTONIO TX
78222-1010
US

V. Phone/Fax

Practice location:
  • Phone: 210-343-2649
  • Fax: 210-892-3669
Mailing address:
  • Phone: 210-643-0671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: GREGORY E BROWN
Title or Position: OWNER
Credential: MD
Phone: 210-643-0671