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General NPI Number Information
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NPI Number | 1619849676
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Entity Type | Organization
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Legal Business Name | THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 903 W MARTIN ST
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City | SAN ANTONIO
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State | TX
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Zip | 78207-0903
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Country | US
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Telephone | 210-358-3985
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Fax | 210-358-5942
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Provider Business Mailing Address
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Address Line | 8431 FREDERICKSBURG RD
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3392
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Country | US
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Telephone | 210-450-4621
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Fax | 210-450-4903
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Authorized Official
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Title or Position | SR DIRECTOR, MED STAFF SERVICE
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Name | REGINA LYNN DETTY
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Credential |
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Telephone | 210-450-4736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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