Healthcare Provider Details

I. General information

NPI: 1306083738
Provider Name (Legal Business Name): METHODIST HEALTHCARE SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 FLOYD CURL DR PEDIATRIC INTENSIVE CARE UNIT - 2 SOUTH
SAN ANTONIO TX
78229-3902
US

IV. Provider business mailing address

7711 LOUIS PASTEUR SUITE 708
SAN ANTONIO TX
78229
US

V. Phone/Fax

Practice location:
  • Phone: 210-575-7120
  • Fax: 210-575-7123
Mailing address:
  • Phone: 210-575-6919
  • Fax: 210-575-4013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number625493
License Number StateTX

VIII. Authorized Official

Name: DR. PATRICIA TENNER
Title or Position: DIRECTOR OF PEDIATRIC INTENSIVISTS
Credential: M.D.
Phone: 210-575-6919