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General NPI Number Information
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NPI Number | 1467631135
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Entity Type | Organization
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Legal Business Name | J R HOLCOMB MD PA
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 4410 MEDICAL DR STE 360
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3749
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Country | US
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Telephone | 210-614-2100
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Fax | 210-692-1999
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Provider Business Mailing Address
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Address Line | 4410 MEDICAL DR STE 360
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3749
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Country | US
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Telephone | 210-614-2100
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Fax | 210-692-1999
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Authorized Official
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Title or Position | CREDENTIALING
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Name | CLAIRE CLARK
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Credential |
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Telephone | 210-614-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | E4159
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License Number State | TX
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