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General NPI Number Information
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NPI Number | 1952852345
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Entity Type | Organization
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Legal Business Name | HUEBNER AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 10/20/2016
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Last Update Date | 01/19/2018
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Provider Practice Location Address
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Address Line | 9618 HUEBNER RD SUITE 111
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1660
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Country | US
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Telephone | 405-697-2420
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Fax |
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Provider Business Mailing Address
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Address Line | 9618 HUEBNER RD STE 111
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1775
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Country | US
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Telephone | 210-943-0999
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Fax | 210-943-0990
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Authorized Official
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Title or Position | VP-MANAGED CARE CONTRACTING
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Name | TRISHA GRUS
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Credential |
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Telephone | 405-697-2420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 130329
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License Number State | TX
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