Healthcare Provider Details

I. General information

NPI: 1427075308
Provider Name (Legal Business Name): DANIEL S. SA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4330 MEDICAL DR STE 500
SAN ANTONIO TX
78229-3318
US

IV. Provider business mailing address

4330 MEDICAL DR STE 500
SAN ANTONIO TX
78229-3318
US

V. Phone/Fax

Practice location:
  • Phone: 210-732-3668
  • Fax: 210-732-3338
Mailing address:
  • Phone: 210-732-3668
  • Fax: 210-732-3338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberQ1730
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: