Healthcare Provider Details

I. General information

NPI: 1326342015
Provider Name (Legal Business Name): B.S.ATHREYA,M.D.,P.A.& ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2011
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 E QUINCY ST STE 430
SAN ANTONIO TX
78215-2034
US

IV. Provider business mailing address

215.EAST QUINCY STREET. SUITE # 430
SAN ANTONIO TX
78215
US

V. Phone/Fax

Practice location:
  • Phone: 210-225-4641
  • Fax: 210-226-3610
Mailing address:
  • Phone: 210-225-4641
  • Fax: 210-226-3610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG4520
License Number StateTX

VIII. Authorized Official

Name: DR. BAKTHAVATHSALAM SWAMYNATHAN ATHREYA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 210-225-4641