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NPI Code Detail

MEDICARE: SONTERRA DERMATOLOGY PLLC

MEDICARE: SONTERRA DERMATOLOGY PLLC
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
1174400000XSpecialistN5065TX

General Provider Information

NPI Number : 1285925966
Entity Type Code : Organization
Provider Name (Legal Business Name) : SONTERRA DERMATOLOGY PLLC
Provider Business Mailing Address
First Line : 1314 E SONTERRA BLVD STE 2201
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-4287
Country : US
Telephone Number : 210-496-5792
Fax Number :
Provider Business Practice Location Address
First Line : 1314 E SONTERRA BLVD STE 2201
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78258-4287
Country : US
Telephone Number : 210-496-5792
Fax Number : 210-496-5792
Authorized Official
Title or Position : PRESIDENT
Name : ANNABELLE L GARCIA
Credential : M.D.
Telephone Number : 210-496-5792
Provider Enumeration Date : 04/28/2011
Last Update Date : 07/21/2022

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Directions to “SONTERRA DERMATOLOGY PLLC ” Practice Location

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