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NPI Code Detail

MEDICARE: SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA

MEDICARE: SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, 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
1207X00000XOrthopaedic Surgery Physician
2207XS0114XAdult Reconstructive Orthopaedic Surgery Physician
3208100000XPhysical Medicine & Rehabilitation Physician
4213ES0103XFoot & Ankle Surgery Podiatrist
5332B00000XDurable Medical Equipment & Medical Supplies
6363A00000XPhysician Assistant
7363LF0000XFamily Nurse Practitioner
8207QS0010XSports Medicine (Family Medicine) Physician

General Provider Information

NPI Number : 1306674981
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA
Provider Business Mailing Address
First Line : 21 SPURS LN STE 300
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78240-1679
Country : US
Telephone Number : 210-756-5240
Fax Number :
Provider Business Practice Location Address
First Line : 430 W SUNSET RD STE 440
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78209-1770
Country : US
Telephone Number : 210-699-8326
Fax Number :
Authorized Official
Title or Position : CREDENTIALING SPECIALIST
Name : JULIE BIRKELO
Credential :
Telephone Number : 210-756-5240
Provider Enumeration Date : 07/24/2024
Last Update Date : 09/30/2024

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Directions to “SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA ” Practice Location

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