Healthcare Provider Details

I. General information

NPI: 1194980698
Provider Name (Legal Business Name): CARDIOLOGY AND ENDOVASCULAR INSTITUTE OF SAN ANTONIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19234 STONEHUE SUITE 104
SAN ANTONIO TX
78258-3477
US

IV. Provider business mailing address

19234 STONEHUE SUITE 104
SAN ANTONIO TX
78258-3477
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 Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberJ7900
License Number StateNV

VIII. Authorized Official

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