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General NPI Number Information
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NPI Number | 1295825990
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Entity Type | Organization
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Legal Business Name | COMMUNITY FAMILY MEDICINE PA
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 07/02/2010
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Provider Practice Location Address
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Address Line | 1616 CALLAGHAN RD
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City | SAN ANTONIO
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State | TX
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Zip | 78228
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Country | US
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Telephone | 210-435-1218
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Fax | 210-435-3162
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Provider Business Mailing Address
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Address Line | 1616 CALLAGHAN RD
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City | SAN ANTONIO
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State | TX
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Zip | 78228
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Country | US
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Telephone | 210-435-1218
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Fax | 210-435-3162
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Authorized Official
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Title or Position | MD LOWNER
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Name | JAVIER C BOCANEGRA
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Credential | MD
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Telephone | 210-435-1218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H2253
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License Number State | TX
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