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General NPI Number Information
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NPI Number | 1336551126
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Entity Type | Organization
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Legal Business Name | UROLOGY SAN ANTONIO PA
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Dates
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Enumeration Date | 05/28/2014
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 18915 MEISNER DR
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4223
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Country | US
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Telephone | 210-499-5158
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Fax | 210-679-3730
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Provider Business Mailing Address
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Address Line | 7909 FREDERICKSBURG RD STE 110
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3400
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Country | US
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Telephone | 210-614-4544
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Fax | 210-679-3720
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE VASSAR
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Credential | MD
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Telephone | 210-731-2050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | G8179
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | G8179
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License Number State | TX
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