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General NPI Number Information
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NPI Number | 1184028698
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Entity Type | Organization
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Legal Business Name | BBC SURGICAL ASSOCIATES OF SAN ANTONIO
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Dates
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Enumeration Date | 10/13/2014
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Last Update Date | 10/13/2014
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Provider Practice Location Address
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Address Line | 12222 N CENTRAL EXPY SUITE 300
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City | DALLAS
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State | TX
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Zip | 75243-3755
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Country | US
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Telephone | 972-270-4800
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Fax | 469-364-3756
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Provider Business Mailing Address
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Address Line | 12222 N CENTRAL EXPY SUITE 300
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City | DALLAS
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State | TX
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Zip | 75243-3755
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Country | US
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Telephone | 972-270-4800
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Fax | 469-364-3756
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Authorized Official
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Title or Position | BILLING/CREDENTIALING MANAGER
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Name | JAVIER JAIMES
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Credential |
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Telephone | 972-270-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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