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General NPI Number Information
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NPI Number | 1366251472
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Entity Type | Organization
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Legal Business Name | SCARLETT PHOENIX INC.
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/05/2025
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Provider Practice Location Address
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Address Line | 914 E ELMIRA ST STE 203
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City | SAN ANTONIO
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State | TX
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Zip | 78212-1716
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Country | US
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Telephone | 210-483-6255
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Fax |
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Provider Business Mailing Address
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Address Line | 914 E ELMIRA ST STE 203
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City | SAN ANTONIO
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State | TX
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Zip | 78212-1716
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Country | US
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Telephone | 210-483-6255
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDRA RUNNELS
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Credential | MD
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Telephone | 210-718-4046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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