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General NPI Number Information
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NPI Number | 1881028801
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO HEART IMAGING, PLLC
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 19276 STONE OAK PKWY SUITE 103 A
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3378
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Country | US
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Telephone | 210-403-9170
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Fax | 210-403-9188
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Provider Business Mailing Address
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Address Line | 19276 STONE OAK PKWY SUITE 103 A
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3378
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Country | US
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Telephone | 210-403-9170
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Fax | 210-403-9188
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD M KOPPES
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Credential | MD
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Telephone | 210-403-9170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | L06569
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License Number State | TX
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