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General NPI Number Information
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NPI Number | 1104942382
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Entity Type | Organization
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Legal Business Name | EPILEPSY FOUNDATION CENTRAL AND SOUTH TEXAS
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 8601 VILLAGE DR STE 220
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5509
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Country | US
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Telephone | 210-653-5353
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Fax | 210-653-5355
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Provider Business Mailing Address
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Address Line | 8601 VILLAGE DR STE 220
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5509
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Country | US
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Telephone | 210-653-5353
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Fax | 210-653-5355
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | KIMBERLY MARTIN
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Credential |
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Telephone | 210-653-5353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084E0001X
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Taxonomy Name | Epilepsy Physician
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License Number |
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License Number State |
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