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General NPI Number Information
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NPI Number | 1659427151
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Entity Type | Organization
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Legal Business Name | NASSER NAKISSA
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 06/22/2008
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Provider Practice Location Address
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Address Line | 700 S ZARZAMORA ST SUITE 208
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City | SAN ANTONIO
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State | TX
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Zip | 78207-5255
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Country | US
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Telephone | 210-434-2488
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Fax | 210-434-3113
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Provider Business Mailing Address
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Address Line | PO BOX 28554
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City | SAN ANTONIO
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State | TX
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Zip | 78228-0554
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Country | US
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Telephone | 210-434-2488
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Fax | 210-434-3113
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Authorized Official
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Title or Position | OWNER
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Name | DR. NASSAR NAKISSA
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Credential | M.D.
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Telephone | 210-434-2488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 101130
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License Number State | TX
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