Healthcare Provider Details

I. General information

NPI: 1568209252
Provider Name (Legal Business Name): STARHOPE LIVER CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2024
Last Update Date: 07/11/2024
Certification Date: 07/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3303 ROGERS RD STE 230
SAN ANTONIO TX
78251-3688
US

IV. Provider business mailing address

19179 BLANCO RD STE 105-249
SAN ANTONIO TX
78258-4042
US

V. Phone/Fax

Practice location:
  • Phone: 210-833-4927
  • Fax:
Mailing address:
  • Phone: 210-833-4927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number
License Number State

VIII. Authorized Official

Name: FERNANDO E MEMBRENO
Title or Position: OWNER
Credential: MD
Phone: 210-833-4927