MEDICARE: MEDICAL VEIN CLINIC

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	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1538696471
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL VEIN CLINIC

Provider Business Mailing Address
First Line	:	18831 MEISNER DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4240
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18831 MEISNER DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4240
Country	:	US
Telephone Number	:	210-622-8000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN S HOGG
Credential	:	MD
Telephone Number	:	512-289-2198

Provider Enumeration Date	:	05/22/2017
Last Update Date	:	06/25/2026

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Directions to “MEDICAL VEIN CLINIC ” Practice Location

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