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General NPI Number Information
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NPI Number | 1578676110
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Entity Type | Organization
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Legal Business Name | STEPHEN VAN CLEAVEMD PA
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 8038 WURZBACH RD SUITE 250
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3817
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Country | US
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Telephone | 210-692-0048
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Fax |
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Provider Business Mailing Address
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Address Line | 8038 WURZBACH RD SUITE 250
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3817
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. STEPHEN VAN CLEAVE
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Credential | MD, PA
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Telephone | 210-692-0048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E2909
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License Number State | TX
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