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General NPI Number Information
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NPI Number | 1629401617
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Entity Type | Organization
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Legal Business Name | VR SURGICAL ASSOCIATES PA
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 497 10TH ST
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City | FLORESVILLE
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State | TX
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Zip | 78114-3179
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Country | US
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Telephone | 210-614-3565
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Fax | 210-614-3563
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Provider Business Mailing Address
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Address Line | 4499 MEDICAL DR STE 250
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3712
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Country | US
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Telephone | 210-614-3565
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Fax | 210-614-3563
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Authorized Official
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Title or Position | OWNER
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Name | DR. VINCENT A CALDAROLA
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Credential | M.D.
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Telephone | 210-614-3565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | TX
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