MEDICARE: REMINGTON OAKS FAMILY PRACTICE PLLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0069EZ	OTHER	TX	GROUP BCBS

General Provider Information

NPI Number	:	1629093422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REMINGTON OAKS FAMILY PRACTICE PLLC

Provider Business Mailing Address
First Line	:	525 OAK CENTRE DR STE 150
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3917
Country	:	US
Telephone Number	:	210-297-4550
Fax Number	:	210-297-0450

Provider Business Practice Location Address
First Line	:	525 OAK CENTRE DR STE 150
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3917
Country	:	US
Telephone Number	:	210-297-4550
Fax Number	:	210-297-0450

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CYNDI J CHOATE
Credential	:
Telephone Number	:	210-297-4550

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	01/06/2011

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