MEDICARE: SAN ANTONIO COMPREHENSIVE CARE OB/GYN

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	A78213	CA
2	207V00000X	Obstetrics & Gynecology Physician	P0716	TX

General Provider Information

NPI Number	:	1730448937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAN ANTONIO COMPREHENSIVE CARE OB/GYN

Provider Business Mailing Address
First Line	:	7003 S. NEW BRAUNFELS AVE
Second Line	:	SUITE 101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223
Country	:	US
Telephone Number	:	210-333-4700
Fax Number	:	210-579-1685

Provider Business Practice Location Address
First Line	:	7003 S. NEW BRAUNFELS AVE
Second Line	:	SUITE 101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223
Country	:	US
Telephone Number	:	210-333-4700
Fax Number	:	210-579-1685

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MELHEM DANDAN
Credential	:	MD
Telephone Number	:	210-333-4700

Provider Enumeration Date	:	05/08/2012
Last Update Date	:	09/12/2012

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Directions to “SAN ANTONIO COMPREHENSIVE CARE OB/GYN ” Practice Location

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