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General NPI Number Information
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NPI Number | 1558549162
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Entity Type | Organization
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Legal Business Name | PEDIATRIC MEDICINE, P.A.
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 7922 EWING HALSELL DR SUITE 440
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3786
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Country | US
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Telephone | 210-614-2500
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Fax | 210-614-2755
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Provider Business Mailing Address
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Address Line | 7922 EWING HALSELL DR SUITE 440
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3786
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Country | US
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Telephone | 210-614-2500
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Fax | 210-614-2755
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL A. OZER
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Credential | M.D.
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Telephone | 210-614-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | D8376
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License Number State | TX
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