Healthcare Provider Details

I. General information

NPI: 1801854591
Provider Name (Legal Business Name): SAN ANTONIO SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 10/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 SPURS LN SUBLEVEL 100
SAN ANTONIO TX
78240-1669
US

IV. Provider business mailing address

21 SPURS LN SUBLEVEL 100
SAN ANTONIO TX
78240-1669
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-0187
  • Fax:
Mailing address:
  • Phone: 210-614-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number000171
License Number StateTX

VIII. Authorized Official

Name: ERIC RANDELL DAY
Title or Position: ADMINISTRATOR
Credential:
Phone: 210-614-0187