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General NPI Number Information
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NPI Number | 1144650060
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO CHILDRENS SURGICAL
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Dates
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Enumeration Date | 11/13/2013
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 8706 FREDERICKSBURG RD STE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1293
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Country | US
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Telephone | 210-598-7918
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Fax |
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Provider Business Mailing Address
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Address Line | 8706 FREDERICKSBURG RD SUITE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1200
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Country | US
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Telephone | 713-481-9500
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DEVIN LARSEN
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Credential |
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Telephone | 713-489-2198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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