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General NPI Number Information
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NPI Number | 1427148378
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Entity Type | Organization
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Legal Business Name | NEUROLOGY CENTER OF SAN ANTONIO PA
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 1314 E SONTERRA BLVD #601
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4278
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Country | US
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Telephone | 210-490-0016
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Fax | 210-490-3010
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Provider Business Mailing Address
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Address Line | 1314 E SONTERRA BLVD #601
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4278
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Country | US
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Telephone | 210-490-0016
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Fax | 210-490-3010
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Authorized Official
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Title or Position | PRES CEO
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Name | ANN DOAN BASS
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Credential | M.D.
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Telephone | 210-490-0016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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