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General NPI Number Information
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NPI Number | 1366631020
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO ADVANCED MEDICAL GROUP PA
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 01/26/2013
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Provider Practice Location Address
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Address Line | 134 MENGER SPGS SUITE 1210
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City | BOERNE
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State | TX
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Zip | 78006-7218
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Country | US
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Telephone | 210-698-9841
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Fax | 210-698-9863
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Provider Business Mailing Address
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Address Line | 24165 IH 10 W SUITE 217, BOX 644
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1159
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Country | US
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Telephone | 210-698-9841
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Fax | 210-698-9863
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | RACHEL A SANCHEZ
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Credential |
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Telephone | 210-698-9841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G7947
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License Number State | TX
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