MEDICARE: SARA J. APSLEY-AMBRIZ, D.O.

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	207Q00000X	Family Medicine Physician	G4792	TX

General Provider Information

NPI Number	:	1619191194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARA J. APSLEY-AMBRIZ, D.O.

Provider Business Mailing Address
First Line	:	4466 LOCKHILL SELMA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2078
Country	:	US
Telephone Number	:	210-694-4081
Fax Number	:	210-696-8053

Provider Business Practice Location Address
First Line	:	4466 LOCKHILL SELMA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2078
Country	:	US
Telephone Number	:	210-694-4081
Fax Number	:	210-696-8053

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. SARA JANE APSLEYAMBRIZ
Credential	:	D.O.
Telephone Number	:	210-694-4081

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	02/05/2008

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