MEDICARE: BIRTH CENTER STONE OAK 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
1	261QB0400X	Birthing Clinic/Center		TX

General Provider Information

NPI Number	:	1225396542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BIRTH CENTER STONE OAK LLC

Provider Business Mailing Address
First Line	:	27031 GRANITE PATH
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-1951
Country	:	US
Telephone Number	:	210-273-0043
Fax Number	:	210-481-0992

Provider Business Practice Location Address
First Line	:	21708 HARDY OAK BLVD
Second Line	:	#102
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4859
Country	:	US
Telephone Number	:	210-481-7549
Fax Number	:	210-481-7562

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. REBECCA BROCK ARANIBAR
Credential	:	MBA
Telephone Number	:	210-273-0043

Provider Enumeration Date	:	04/24/2012
Last Update Date	:	04/24/2012

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