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General NPI Number Information
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NPI Number | 1023099058
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Entity Type | Individual
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Provider Name | ANDY GLENN SCOTT PA
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 02/18/2015
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Provider Practice Location Address
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Address Line | 333 N SANTA ROSA ST
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City | SAN ANTONIO
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State | TX
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Zip | 78207-3108
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Country | US
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Telephone | 210-704-2190
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Fax | 210-704-4527
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Provider Business Mailing Address
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Address Line | 315 N SAN SABA STE 1135
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City | SAN ANTONIO
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State | TX
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Zip | 78207-3154
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Country | US
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Telephone | 210-704-2937
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Fax | 210-704-4527
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA03410
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License Number State | TX
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