Healthcare Provider Details

I. General information

NPI: 1134434780
Provider Name (Legal Business Name): WHOLE WOMAN'S HEALTH OF SAN ANTONIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4025 E SOUTHCROSS BLVD BUILDING 3
SAN ANTONIO TX
78222-3641
US

IV. Provider business mailing address

8401 N I H 35 SUITE 1A
AUSTIN TX
78753-5751
US

V. Phone/Fax

Practice location:
  • Phone: 512-835-6858
  • Fax:
Mailing address:
  • Phone: 512-835-6858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. VIRGINIA E SMITH
Title or Position: BILLING COORDINATOR
Credential:
Phone: 888-737-9615