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General NPI Number Information
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NPI Number | 1326342015
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Entity Type | Organization
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Legal Business Name | B.S.ATHREYA,M.D.,P.A.& ASSOCIATES
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Dates
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Enumeration Date | 01/10/2011
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Last Update Date | 01/10/2011
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Provider Practice Location Address
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Address Line | 215 E QUINCY ST STE 430
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City | SAN ANTONIO
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State | TX
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Zip | 78215-2034
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Country | US
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Telephone | 210-225-4641
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Fax | 210-226-3610
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Provider Business Mailing Address
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Address Line | 215.EAST QUINCY STREET. SUITE # 430
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City | SAN ANTONIO
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State | TX
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Zip | 78215
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Country | US
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Telephone | 210-225-4641
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Fax | 210-226-3610
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BAKTHAVATHSALAM SWAMYNATHAN ATHREYA
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Credential | M.D.
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Telephone | 210-225-4641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G4520
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License Number State | TX
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