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General NPI Number Information
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NPI Number | 1265160196
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO INSTITUTE OF DIABETES, THYROID & ENDOCRINE DISORDERS, INC
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 4025 E SOUTHCROSS BLVD STE 7
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City | SAN ANTONIO
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State | TX
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Zip | 78222-3640
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Country | US
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Telephone | 210-267-9229
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Fax | 210-267-8005
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Provider Business Mailing Address
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Address Line | 4025 E SOUTHCROSS BLVD STE 7
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City | SAN ANTONIO
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State | TX
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Zip | 78222-3640
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Country | US
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Telephone | 210-267-9229
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Fax | 210-267-8005
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | MARLISE NEGRETTE
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Credential |
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Telephone | 909-793-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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