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General NPI Number Information
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NPI Number | 1205089406
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Entity Type | Organization
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Legal Business Name | PEDIATRIC ANESTHESIA CONSULTANTS OF SAN ANTONIO PLLC
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 7700 FLOYD CURL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3902
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Country | US
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Telephone | 210-575-7827
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Fax | 866-741-3697
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Provider Business Mailing Address
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Address Line | 7711 LOUIS PASTEUR DR STE 708
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3415
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Country | US
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Telephone | 210-575-7828
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Fax | 866-741-3697
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Authorized Official
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Title or Position | VICE PRESIDENT OF MANAGING MEMBER
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Name | MS. ROBERTA S CLOUD
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Credential |
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Telephone | 210-575-7827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number |
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License Number State |
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