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General NPI Number Information
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NPI Number | 1063061414
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Entity Type | Organization
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Legal Business Name | HOSPITAL SAN ANTONIO
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | CARETERA 23
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City | CHAPALA
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State | JA
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Zip | 45920
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Country | MX
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Telephone | 888-449-7799
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Fax |
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Provider Business Mailing Address
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Address Line | 539 W COMMERCE ST STE 43200
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City | DALLAS
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State | TX
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Zip | 75208-1953
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Country | US
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Telephone | 888-449-7799
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Fax | 888-449-7799
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Authorized Official
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Title or Position | LEGAL REPRESENTATIVE
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Name | JAVIER EZQUERRA
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Credential | DR
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Telephone | 888-449-7799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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