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General NPI Number Information
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NPI Number | 1881639615
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Entity Type | Organization
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Legal Business Name | ACD-SA, LTD.
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 7220 LOUIS PASTEUR DR 115
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4537
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Country | US
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Telephone | 210-614-8899
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Fax | 512-458-6770
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Provider Business Mailing Address
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Address Line | PO BOX 301749
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City | AUSTIN
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State | TX
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Zip | 78703-0030
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Country | US
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Telephone | 512-454-9597
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Fax | 512-458-6770
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. TARA J MARTIN
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Credential |
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Telephone | 512-454-9598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 000393
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State | TX
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