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NPI Code Detail

MEDICARE: 5 STAR INTEGRITY HEALTHCARE, LLC

MEDICARE: 5 STAR INTEGRITY HEALTHCARE, LLC
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
1363AM0700XMedical Physician Assistant
2363LA2100XAcute Care Nurse Practitioner
3363LF0000XFamily Nurse Practitioner
4363LW0102XWomen's Health Nurse Practitioner
5207R00000XInternal Medicine Physician
6208D00000XGeneral Practice Physician
7207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1194210658
Entity Type Code : Organization
Provider Name (Legal Business Name) : 5 STAR INTEGRITY HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 1300 WEST AVE STE 201
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-3501
Country : US
Telephone Number : 210-708-9329
Fax Number : 210-817-8686
Provider Business Practice Location Address
First Line : 1300 WEST AVE STE 201
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-3501
Country : US
Telephone Number : 210-708-9329
Fax Number : 210-817-8686
Authorized Official
Title or Position : OWNER
Name : PATRICIA V GOMEZ
Credential :
Telephone Number : 210-708-9329
Provider Enumeration Date : 06/27/2018
Last Update Date : 04/27/2020

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Directions to “5 STAR INTEGRITY HEALTHCARE, LLC ” Practice Location

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