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General NPI Number Information
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NPI Number | 1548757545
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Entity Type | Organization
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Legal Business Name | QUANTUM PAIN AND ORTHOPEDIC, PLLC
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Dates
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Enumeration Date | 04/16/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 8626 TESORO DR STE 112
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6217
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Country | US
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Telephone | 210-817-6010
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Fax | 210-817-6011
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Provider Business Mailing Address
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Address Line | 8626 TESORO DR STE 112
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6217
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Country | US
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Telephone | 210-817-6010
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Fax | 210-817-6011
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Authorized Official
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Title or Position | OWNER
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Name | SAM K LI
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Credential | MD
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Telephone | 210-817-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | R4868
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License Number State | TX
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