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NPI Code Detail

MEDICARE: SOUTHSIDE ORTHOPAEDIC & REHABILITATION ASSOCIATES PA.

MEDICARE: SOUTHSIDE ORTHOPAEDIC & REHABILITATION ASSOCIATES PA.
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
1261QM2500XMedical Specialty Clinic/CenterE7415TX

General Provider Information

NPI Number : 1134395593
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHSIDE ORTHOPAEDIC & REHABILITATION ASSOCIATES PA.
Provider Business Mailing Address
First Line : 303 E QUINCY
Second Line : SUITE 102
City : SAN ANTONIO
State : TX
Zip : 78215-1922
Country : US
Telephone Number : 210-922-0621
Fax Number : 210-927-1171
Provider Business Practice Location Address
First Line : 303 E QUINCY
Second Line : SUITE 102
City : SAN ANTONIO
State : TX
Zip : 78215-1922
Country : US
Telephone Number : 210-922-0621
Fax Number : 210-927-1171
Authorized Official
Title or Position : OWNER
Name : DR. PABLO GUAJARDO
Credential : M.D.
Telephone Number : 210-922-0621
Provider Enumeration Date : 05/06/2008
Last Update Date : 07/28/2014

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Directions to “SOUTHSIDE ORTHOPAEDIC & REHABILITATION ASSOCIATES PA. ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.