Healthcare Provider Details

I. General information

NPI: 1306241625
Provider Name (Legal Business Name): MGB PLASTIC SURGERY ASSOCIATES OF SAN ANTONIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2014
Last Update Date: 10/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 FLOYD CURL DR STE 904
SAN ANTONIO TX
78229-3919
US

IV. Provider business mailing address

7950 FLOYD CURL DR STE 904
SAN ANTONIO TX
78229-3919
US

V. Phone/Fax

Practice location:
  • Phone: 210-616-0798
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW G BINDEWALD
Title or Position: OWNER
Credential: MD
Phone: 805-698-1559