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General NPI Number Information
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NPI Number | 1417810805
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER - SHAVANO PARK
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 14603 HUEBNER RD BLDG 41
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City | SAN ANTONIO
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State | TX
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Zip | 78230-5505
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Country | US
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Telephone | 210-468-5426
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Fax |
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Provider Business Mailing Address
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Address Line | 14603 HUEBNER RD BLDG 41
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City | SAN ANTONIO
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State | TX
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Zip | 78230-5505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF OF STAFF
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Name | JOSE E BARRERA
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Credential | MD
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Telephone | 210-468-5426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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