Healthcare Provider Details

I. General information

NPI: 1477993327
Provider Name (Legal Business Name): O2 DOCS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 05/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 NAVARRO ST STE 502
SAN ANTONIO TX
78205-2580
US

IV. Provider business mailing address

6222 HICKORY HOLW
WINDCREST TX
78239-2720
US

V. Phone/Fax

Practice location:
  • Phone: 210-223-1145
  • Fax: 210-615-7619
Mailing address:
  • Phone: 210-385-5001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberJ7669
License Number StateTX

VIII. Authorized Official

Name: DR. KHAN SHIRANI
Title or Position: PRESIDENT
Credential: MD
Phone: 210-223-1145