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General NPI Number Information
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NPI Number | 1932774080
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Entity Type | Organization
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Legal Business Name | CEPAMERICA TEXAS PA
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 11212 STATE HIGHWAY 151
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4498
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Country | US
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Telephone | 210-703-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 POWELL ST STE 400
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City | EMERYVILLE
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State | CA
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Zip | 94608-1826
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Country | US
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Telephone | 510-350-2600
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Fax |
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | DAVID ANDREW BIRDSALL
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Credential | MD
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Telephone | 510-350-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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