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NPI Code Detail

MEDICARE: THI OF TEXAS AT SAN ANTONIO II, LLC

MEDICARE: THI OF TEXAS AT SAN ANTONIO II, LLC
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
1282E00000XLong Term Care Hospital

General Provider Information

NPI Number : 1568559755
Entity Type Code : Organization
Provider Name (Legal Business Name) : THI OF TEXAS AT SAN ANTONIO II, LLC
Provider Business Mailing Address
First Line : 930 RIDGEBROOK RD
Second Line :
City : SPARKS
State : MD
Zip : 21152-9390
Country : US
Telephone Number : 410-773-1000
Fax Number :
Provider Business Practice Location Address
First Line : 7310 OAK MANOR DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-4509
Country : US
Telephone Number : 210-308-0261
Fax Number : 210-308-5972
Authorized Official
Title or Position : PRESIDENT
Name : LARRY WITTIGAN
Credential :
Telephone Number : 210-308-0261
Provider Enumeration Date : 10/07/2006
Last Update Date : 03/31/2008

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Directions to “THI OF TEXAS AT SAN ANTONIO II, LLC ” Practice Location

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