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General NPI Number Information
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NPI Number | 1518787845
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS SPECIALTY CARE PLLC
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 225 E SONTERRA BLVD STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3995
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Country | US
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Telephone | 210-550-2877
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Fax | 210-866-4587
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Provider Business Mailing Address
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Address Line | 19236 REATA TRL
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4025
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Country | US
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Telephone | 210-550-5531
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Fax | 210-866-4587
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Authorized Official
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Title or Position | MEMBER
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Name | CYRIL COMPTON GAIENNIE III
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Credential | DNP
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Telephone | 210-550-2877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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