Healthcare Provider Details

I. General information

NPI: 1942466651
Provider Name (Legal Business Name): BEXAR COUNTY DETENTION MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 SAN PEDRO AVE
SAN ANTONIO TX
78212-5057
US

IV. Provider business mailing address

503 SAN PEDRO AVE
SAN ANTONIO TX
78212-5057
US

V. Phone/Fax

Practice location:
  • Phone: 210-299-4540
  • Fax: 210-299-1193
Mailing address:
  • Phone: 210-299-4540
  • Fax: 210-299-1193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CAROL LOCKETT
Title or Position: EXECUTUVE DIRECTOR
Credential:
Phone: 210-299-4540