Healthcare Provider Details

I. General information

NPI: 1669765608
Provider Name (Legal Business Name): INPATIENT CARE OF SOUTH TEXAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 STAPLES RD
SAN MARCOS TX
78666-1426
US

IV. Provider business mailing address

PO BOX 90436
SAN ANTONIO TX
78209-9084
US

V. Phone/Fax

Practice location:
  • Phone: 512-535-0322
  • Fax: 512-535-6002
Mailing address:
  • Phone: 512-213-1122
  • Fax: 512-535-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: PABLO LOZADA
Title or Position: OWNER
Credential: MD
Phone: 512-213-1122