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General NPI Number Information
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NPI Number | 1962661884
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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 | 06/05/2008
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 7220 LOUIS PASTEUR SUITE 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 |
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Provider Business Mailing Address
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Address Line | 711 W 38TH ST SUITE D-1
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City | AUSTIN
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State | TX
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Zip | 78705-1121
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Country | US
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Telephone | 512-454-9598
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Fax |
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Authorized Official
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Title or Position | COO
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Name | TARA 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 | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 000393
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License Number State | TX
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