Healthcare Provider Details
I. General information
NPI: 1679692545
Provider Name (Legal Business Name): TEXAS INPATIENT PHYSICIANS ASSOCIATION, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18850 REDLAND RD
SAN ANTONIO TX
78259-3570
US
IV. Provider business mailing address
PO BOX 701194
SAN ANTONIO TX
78270-1194
US
V. Phone/Fax
- Phone: 210-384-0011
- Fax: 210-490-1931
- Phone: 210-384-0011
- Fax: 210-490-1931
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CHRIS
MATHIS
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 210-490-5547