Healthcare Provider Details

I. General information

NPI: 1457093684
Provider Name (Legal Business Name): FATMA MUGE OZGUC DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 06/19/2022
Certification Date: 06/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4502 MEDICAL DR
SAN ANTONIO TX
78229-4402
US

IV. Provider business mailing address

8639 FAIRHAVEN ST APT 3405
SAN ANTONIO TX
78229-2473
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-3555
  • Fax:
Mailing address:
  • Phone: 832-310-9543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: