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General NPI Number Information
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NPI Number | 1336415371
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Entity Type | Organization
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Legal Business Name | PRECISION SPINE AND PAIN MANAGEMENT
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Dates
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Enumeration Date | 03/23/2012
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 1642 LOCKHILL SELMA ROAD
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City | SAN ANTONIO
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State | TX
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Zip | 78213
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Country | US
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Telephone | 210-233-9331
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Fax | 210-233-9454
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Provider Business Mailing Address
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Address Line | 1642 LOCKHILL SELMA ROAD
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City | SAN ANTONIO
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State | TX
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Zip | 78213
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Country | US
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Telephone | 210-233-9331
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Fax | 210-233-9454
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JUAN SOTO
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Credential |
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Telephone | 210-233-9331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | M2907
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License Number State | TX
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