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General NPI Number Information
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NPI Number | 1669701959
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Entity Type | Organization
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Legal Business Name | GREATER SA HOUSE CALLS, LLC
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 5309 WURZBACH RD STE 106
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City | SAN ANTONIO
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State | TX
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Zip | 78238-2431
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Country | US
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Telephone | 210-647-4671
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Fax | 210-647-7552
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Provider Business Mailing Address
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Address Line | 9531 AUTUMN BREEZE
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City | SAN ANTONIO
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State | TX
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Zip | 78254-1969
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Country | US
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Telephone | 210-647-4671
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Fax | 210-647-7552
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Authorized Official
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Title or Position | OWNER
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Name | MR. UGHANMWAN TOKUNBOR EFEOVBOKHAN
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Credential | GNP
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Telephone | 210-789-1274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine 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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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