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General NPI Number Information
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NPI Number | 1700020682
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Entity Type | Organization
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Legal Business Name | FIRST STEPS PEDIATRICS, PLLC
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 9910 W. LOOP 1604 N. SUITE 124
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City | SAN ANTONIO
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State | TX
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Zip | 78254
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Country | US
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Telephone | 210-692-0358
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Fax | 210-692-0359
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Provider Business Mailing Address
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Address Line | 9910 W. LOOP 1604 N. SUITE 124
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City | SAN ANTONIO
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State | TX
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Zip | 78254
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Country | US
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Telephone | 210-692-0358
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Fax | 210-692-0359
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. BRUCE RICHARD LANTRY
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Credential | M.D.
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Telephone | 210-692-0358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K2944
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License Number State | TX
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