MEDICARE: OVERCOME OPIOID ADDICTION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QA0401X	Addiction Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1043835036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OVERCOME OPIOID ADDICTION

Provider Business Mailing Address
First Line	:	303 W SUNSET RD STE 102
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1744
Country	:	US
Telephone Number	:	210-660-8760
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 W SUNSET RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1749
Country	:	US
Telephone Number	:	210-660-8760
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ROBERT MORIN JR.
Credential	:	MD
Telephone Number	:	210-660-8760

Provider Enumeration Date	:	06/15/2020
Last Update Date	:	06/15/2020

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Directions to “OVERCOME OPIOID ADDICTION ” Practice Location

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