Healthcare Provider Details

I. General information

NPI: 1164597852
Provider Name (Legal Business Name): CITY OF SAN ANTONIO TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

512 E HIGHLAND BLVD # 150
SAN ANTONIO TX
78210-3521
US

IV. Provider business mailing address

100 W HOUSTON ST FL 14
SAN ANTONIO TX
78205-1414
US

V. Phone/Fax

Practice location:
  • Phone: 210-207-8830
  • Fax: 210-207-8999
Mailing address:
  • Phone: 210-207-8689
  • Fax: 210-207-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY HAYNES
Title or Position: BILLING AND CODING SPECIALIST
Credential:
Phone: 210-207-8689