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General NPI Number Information
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NPI Number | 1417921834
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 25753 OLD FREDERICKSBURG
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City | BOERNE
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State | TX
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Zip | 78015
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Country | US
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Telephone | 210-450-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 8431 FREDERICKSBURG RD FL 1
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3392
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Country | US
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Telephone | 210-450-9000
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Fax | 210-450-4903
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Authorized Official
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Title or Position | VP OF BUSINESS AFFAIRS
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Name | ANDREA S. MARKS
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Credential | M.B.A., C.P.A.
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Telephone | 210-567-7020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology 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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State | TX
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