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General NPI Number Information
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NPI Number | 1629201546
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Entity Type | Organization
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Legal Business Name | MEDICAL THERAPY & RESEARCH, PLLC
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 2130 N.E.LOOP 410 SUITE #250
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City | SAN ANTONIO
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State | TX
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Zip | 78217
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Country | US
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Telephone | 210-227-5680
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Fax | 210-227-5042
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Provider Business Mailing Address
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Address Line | 2130 N.E.LOOP 410 SUITE #250
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City | SAN ANTONIO
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State | TX
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Zip | 78217
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Country | US
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Telephone | 210-227-5680
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Fax | 210-227-5042
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. STEPHEN CARL COHEN
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Credential | M.D.
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Telephone | 210-227-5680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | E3883
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License Number State | TX
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