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General NPI Number Information
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NPI Number | 1275545519
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Entity Type | Organization
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Legal Business Name | PSYCHIATRIC ASSOCIATES OF SAN ANTONIO
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 343 W HOUSTON ST SUITE 301
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2107
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Country | US
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Telephone | 210-225-3764
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Fax | 210-226-7153
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Provider Business Mailing Address
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Address Line | 343 W HOUSTON ST SUITE 301
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2107
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Country | US
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Telephone | 210-225-3764
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Fax | 210-226-7153
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Authorized Official
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Title or Position | PSYCHIATRY M.D
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Name | DR. DAMASO ANDRES OLIVA SR.
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Credential | M.D
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Telephone | 210-225-3764
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D5563
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License Number State | TX
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