Healthcare Provider Details

I. General information

NPI: 1508923442
Provider Name (Legal Business Name): HEALTHCARE EXECUTIVES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 POTEET JOURDANTON FWY STE 120
SAN ANTONIO TX
78224-1274
US

IV. Provider business mailing address

1007 POTEET JOURDANTON FWY STE 120
SAN ANTONIO TX
78224-1274
US

V. Phone/Fax

Practice location:
  • Phone: 210-921-1599
  • Fax: 210-921-2088
Mailing address:
  • Phone: 210-921-1599
  • Fax: 210-921-2088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANCIS JEFFERY POTTENGER
Title or Position: PRESIDENT
Credential: P.T.
Phone: 210-921-1599