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General NPI Number Information
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NPI Number | 1699173435
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Entity Type | Individual
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Provider Name | San Antonio Pediatrics : sapediatric.com
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Gender | Female
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Dates
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Enumeration Date | 12/10/2014
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | 2221 Buena Vista Street
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City | SAN ANTONIO
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State | TX
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Zip | 78207
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Country | US
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Telephone | 210-223-3543
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Fax | 210-227-0282
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Provider Business Mailing Address
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Address Line | 315 North San Saba Street #1075
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City | San Antonio
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State | TX
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Zip | 78207
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Country | US
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Telephone | 210-223-3543
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Fax | 210-227-0282
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Practitioner
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License Number | AP126307
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License Number State | TX
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