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General NPI Number Information
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NPI Number | 1437767795
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Entity Type | Organization
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Legal Business Name | BEXARAID,LLC.
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Dates
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Enumeration Date | 07/22/2020
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 2015 BROADWAY ST
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1117
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Country | US
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Telephone | 830-582-4029
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Fax |
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Provider Business Mailing Address
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Address Line | 110 E HOUSTON ST # 7TH
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2990
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Country | US
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Telephone | 210-387-4059
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MEGHAN ALEXANDRA GARZA
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Credential |
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Telephone | 830-582-4029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246R00000X
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Taxonomy Name | Pathology Technician
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License Number |
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License Number State |
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