Healthcare Provider Details

I. General information

NPI: 1427489731
Provider Name (Legal Business Name): BACEL NSEIR MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8042 WURZBACH RD SUITE 280
SAN ANTONIO TX
78229-3818
US

IV. Provider business mailing address

8042 WURZBACH RD SUITE 280
SAN ANTONIO TX
78229-3818
US

V. Phone/Fax

Practice location:
  • Phone: 210-614-8100
  • Fax: 210-614-8059
Mailing address:
  • Phone: 210-614-8100
  • Fax: 210-614-8059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD202047
License Number StateLA

VIII. Authorized Official

Name: DR. BACEL NSEIR
Title or Position: OWNER
Credential:
Phone: 210-614-8100