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General NPI Number Information
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NPI Number | 1225560451
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Entity Type | Organization
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Legal Business Name | STSSH PHYSICIANS ORGANIZATION
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 18600 HARDY OAK BLVD
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4206
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Country | US
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Telephone | 210-507-4170
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Fax | 210-579-7388
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Provider Business Mailing Address
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Address Line | 18600 HARDY OAK BLVD
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4206
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Country | US
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Telephone | 210-507-4170
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Fax | 210-579-7388
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Authorized Official
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Title or Position | CEO
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Name | MR. THOMAS KLAWITER
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Credential |
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Telephone | 210-507-4091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 007868
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License Number State | TX
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