Healthcare Provider Details

I. General information

NPI: 1174716971
Provider Name (Legal Business Name): EDWARD E HORVATH DO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8715 VILLAGE DR SUITE 608
SAN ANTONIO TX
78217-5405
US

IV. Provider business mailing address

8715 VILLAGE DR SUITE 608
SAN ANTONIO TX
78217-5405
US

V. Phone/Fax

Practice location:
  • Phone: 210-657-2100
  • Fax: 210-657-2110
Mailing address:
  • Phone: 210-657-2100
  • Fax: 210-657-2110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberM5761
License Number StateTX

VIII. Authorized Official

Name: EDWARD ERIC HORVATH
Title or Position: PRESIDENT
Credential: DO PA
Phone: 210-657-2100