Healthcare Provider Details

I. General information

NPI: 1366687253
Provider Name (Legal Business Name): SALVATORE A BARBARO III MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2008
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19016 STONE OAK PKWY STE 190
SAN ANTONIO TX
78258-3280
US

IV. Provider business mailing address

PO BOX 1196
SAN ANTONIO TX
78294-1196
US

V. Phone/Fax

Practice location:
  • Phone: 210-490-4600
  • Fax: 210-490-4651
Mailing address:
  • Phone: 210-490-4600
  • Fax: 210-490-4651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberJ7900
License Number StateTX

VIII. Authorized Official

Name: DR. SALVATORE A BARBARO III
Title or Position: OWNER
Credential: MD
Phone: 210-490-4600