Healthcare Provider Details
I. General information
NPI: 1932161031
Provider Name (Legal Business Name): ACCORD MEDICAL MANAGMENT, LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
414 NAVARRO ST 20TH FLOOR
SAN ANTONIO TX
78205-2516
US
IV. Provider business mailing address
414 NAVARRO ST SUITE 600
SAN ANTONIO TX
78205-2516
US
V. Phone/Fax
- Phone: 210-271-2188
- Fax: 210-271-2023
- Phone: 210-271-2188
- Fax: 210-271-2023
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 000396 |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
LESTER
E
SURROCK
Title or Position: SENIOR VICE PRESIDENT & CFO
Credential: CPA
Phone: 210-271-2190