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NPI Code Detail

MEDICARE: TRAWICK, INC.

MEDICARE: TRAWICK, INC.
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
1293D00000XPhysiological Laboratory11TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PL0226OTHERTXBLUECROSSBLUESHIELD

General Provider Information

NPI Number : 1093709115
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRAWICK, INC.
Provider Business Mailing Address
First Line : 415 CAMDEN ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78215-1923
Country : US
Telephone Number : 210-223-9019
Fax Number : 210-223-5272
Provider Business Practice Location Address
First Line : 415 CAMDEN ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78215-1923
Country : US
Telephone Number : 210-223-9019
Fax Number : 210-223-5272
Authorized Official
Title or Position : SECRETARY/TRESURER
Name : MRS. MATTIE TRAWICK
Credential :
Telephone Number : 210-223-9019
Provider Enumeration Date : 09/02/2005
Last Update Date : 07/21/2022

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