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General NPI Number Information
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NPI Number | 1679836357
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO CLINICAL GENETICS PA
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 2632 BROADWAY ST SUITE 104 SOUTH
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1137
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Country | US
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Telephone | 210-255-2027
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Fax | 210-226-0050
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Provider Business Mailing Address
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Address Line | 2632 BROADWAY ST SUITE 104 SOUTH
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1137
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Country | US
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Telephone | 210-255-2027
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Fax | 210-226-0050
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. SCOTT D MCLEAN
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Credential | M.D.
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Telephone | 210-255-2027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number |
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License Number State |
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