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General NPI Number Information
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NPI Number | 1164476933
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Entity Type | Organization
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Legal Business Name | NOVAMED SURGERY CENTER OF SAN ANTONIO LP
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 12838 VISTA DEL NORTE
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City | SAN ANTONIO
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State | TX
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Zip | 78216
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Country | US
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Telephone | 866-631-7890
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Fax | 210-692-7890
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Provider Business Mailing Address
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Address Line | 12838 VISTA DEL NORTE
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City | SAN ANTONIO
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State | TX
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Zip | 78216
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Country | US
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Telephone | 866-631-7890
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Fax | 210-692-7890
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Authorized Official
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Title or Position | OFFICER AND AUTHORIZED OFFICIAL
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Name | JENNIFER BOYD BALDOCK
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Credential |
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Telephone | 615-234-5954
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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 | 008352
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License Number State | TX
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