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General NPI Number Information
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NPI Number | 1346424231
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Entity Type | Organization
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Legal Business Name | JOYCELYN M. THEARD M.D,P.A.
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 19284 STONE OAK PKWY
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City | SAN ANTONIO
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State | TX
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Zip | 78218
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Country | US
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Telephone | 210-268-0120
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Fax | 210-268-0170
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Provider Business Mailing Address
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Address Line | 3338 OAKWELL COURT STE 205
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City | SAN ANTONIO
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State | TX
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Zip | 78218
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Country | US
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Telephone | 210-656-3070
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Fax | 210-268-0170
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | JOYCELYN MARIE THEARD
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Credential | M.D.
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Telephone | 210-268-0120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | F4594
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License Number State | TX
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