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General NPI Number Information
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NPI Number | 1679948392
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Entity Type | Organization
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Legal Business Name | BEXAR COUNTY BOARD OF TRUSTEES FOR MENTAL HEALTH MENTAL RETARDATION
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 6800 PARK TEN BLVD SUITE 200-S
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City | SAN ANTONIO
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State | TX
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Zip | 78213-4211
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Country | US
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Telephone | 210-261-1000
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Fax | 210-261-1821
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Provider Business Mailing Address
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Address Line | 6800 PARK TEN BLVD SUITE 200-S
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City | SAN ANTONIO
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State | TX
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Zip | 78213-4211
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Country | US
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Telephone | 210-261-1000
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Fax | 210-261-1821
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Authorized Official
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Title or Position | CREDENTIALING SUPERVISOR
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Name | EUGENE GARCIA
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Credential |
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Telephone | 210-261-1072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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