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General NPI Number Information
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NPI Number | 1285449918
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Entity Type | Organization
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Legal Business Name | INFUSION CLINIC OF CENTRAL TEXAS PLLC
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 1340 WONDER WORLD DR STE 2203
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City | SAN MARCOS
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State | TX
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Zip | 78666-7791
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Country | US
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Telephone | 512-667-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 WONDER WORLD DR STE 2203
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City | SAN MARCOS
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State | TX
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Zip | 78666-7791
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MBR
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Name | HASSAN ALISSA
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Credential | MD
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Telephone | 512-667-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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