Healthcare Provider Details

I. General information

NPI: 1003839333
Provider Name (Legal Business Name): BST HEALTH SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 JOHN D RYAN BLVD
SAN ANTONIO TX
78245-3500
US

IV. Provider business mailing address

12455 FREEDOM WAY
SAN ANTONIO TX
78245-3526
US

V. Phone/Fax

Practice location:
  • Phone: 210-568-3403
  • Fax: 210-670-8159
Mailing address:
  • Phone: 210-838-6325
  • Fax: 210-838-6315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number115823
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number115823
License Number StateTX

VIII. Authorized Official

Name: BRIAN ENGLUND
Title or Position: CFO, TREASURER
Credential: CPA
Phone: 210-838-6332