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General NPI Number Information
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NPI Number | 1750846135
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Entity Type | Organization
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Legal Business Name | CRESTVIEW HEALTH PLLC
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Dates
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Enumeration Date | 02/09/2019
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Last Update Date | 10/08/2023
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Provider Practice Location Address
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Address Line | 12650 NACOGDOCHES RD
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City | SAN ANTONIO
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State | TX
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Zip | 78217-2118
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Country | US
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Telephone | 440-681-0664
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Fax |
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Provider Business Mailing Address
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Address Line | 12650 NACOGDOCHES RD
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City | SAN ANTONIO
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State | TX
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Zip | 78217-2118
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Country | US
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Telephone | 440-681-0664
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Fax | 210-617-4480
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER AJUFO
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Credential | MD
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Telephone | 440-681-0664
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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