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General NPI Number Information
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NPI Number | 1194992966
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Entity Type | Organization
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Legal Business Name | UTHSC AT SAN ANTONIO
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 7703 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3901
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Country | US
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Telephone | 210-567-4074
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Fax |
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Provider Business Mailing Address
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Address Line | 7703 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3901
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Country | US
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Telephone | 210-567-4074
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN, DEPARTMENT OF PATHOLOGY
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Name | ROBERT REDDICK
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Credential | MD
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Telephone | 210-567-4001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | M0408
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License Number State | TX
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