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General NPI Number Information
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NPI Number | 1639251838
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Entity Type | Organization
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Legal Business Name | BEXAR COUNTY MANAGEMENT CO LLC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 343 W HOUSTON ST SUITE 909
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2107
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Country | US
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Telephone | 210-222-0376
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Fax |
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Provider Business Mailing Address
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Address Line | 1842 LOCKHILL SELMA RD SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78213-1559
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Country | US
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Telephone | 210-348-7654
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOE L GOMEZ
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Credential |
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Telephone | 210-348-7654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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