MEDICARE: RSA-SAN ANTONIO, LLP

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	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1386835171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RSA-SAN ANTONIO, LLP

Provider Business Mailing Address
First Line	:	320 SEVEN SPRINGS WAY
Second Line	:	SUITE 250
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4537
Country	:	US
Telephone Number	:	615-250-1797
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 BARLITE BLVD
Second Line	:	SUITE 103
City	:	SAN ANTONIO
State	:	TX
Zip	:	78224-1362
Country	:	US
Telephone Number	:	210-922-3377
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	LINDA S. EARHART
Credential	:
Telephone Number	:	615-250-1773

Provider Enumeration Date	:	08/06/2007
Last Update Date	:	04/11/2008

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