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NPI Code Detail

MEDICARE: MR. GIORGIO SANT'AMBROGIO M.D.

MEDICARE: MR. GIORGIO SANT'AMBROGIO M.D.
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
12084P0804XChild & Adolescent Psychiatry PhysicianH6576TX

General Provider Information

NPI Number : 1518919216
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GIORGIO SANT'AMBROGIO M.D.
Provider Business Mailing Address
First Line : 234 W BANDERA RD
Second Line :
City : BOERNE
State : TX
Zip : 78006-2805
Country : US
Telephone Number : 830-755-5221
Fax Number : 830-755-5221
Provider Business Practice Location Address
First Line : 17720 CORPORATE WOODS DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78259-3500
Country : US
Telephone Number : 210-491-9400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2006
Last Update Date : 07/08/2007

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