Healthcare Provider Details

I. General information

NPI: 1306093505
Provider Name (Legal Business Name): CEDAR HILLS FAMILY PRACTICE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3166 SE MILITARY DR SUITE 103
SAN ANTONIO TX
78223-3978
US

IV. Provider business mailing address

3166 SE MILITARY DR SUITE 103
SAN ANTONIO TX
78223-3978
US

V. Phone/Fax

Practice location:
  • Phone: 210-298-4711
  • Fax: 210-298-4717
Mailing address:
  • Phone: 210-298-4711
  • Fax: 210-298-4717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES EDWARD WILLIAMS
Title or Position: PRESIDENT/PHYSICIAN
Credential: M.D.
Phone: 210-298-4711