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General NPI Number Information
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NPI Number | 1659970200
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR & HYPERTENSION CLINIC OF SAN ANTONIO
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 1730 SW MILITARY DR STE 110
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City | SAN ANTONIO
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State | TX
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Zip | 78221-1400
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Country | US
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Telephone | 210-924-3278
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 128
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City | BELLAIRE
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State | TX
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Zip | 77402-0128
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Country | US
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Telephone | 210-924-3278
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Fax | 210-756-6199
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Authorized Official
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Title or Position | OWNER
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Name | JUAN DIEGO MARTINEZ
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Credential | MD
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Telephone | 210-727-2680
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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