MEDICARE: SARA D MCCAMISH MD PA

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	173000000X	Legal Medicine	L7478	TX

General Provider Information

NPI Number	:	1780880666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARA D MCCAMISH MD PA

Provider Business Mailing Address
First Line	:	4125 MCCULLOUGH AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-1903
Country	:	US
Telephone Number	:	210-826-2822
Fax Number	:	210-826-3372

Provider Business Practice Location Address
First Line	:	4125 MCCULLOUGH AVE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-1903
Country	:	US
Telephone Number	:	210-826-2822
Fax Number	:	210-826-3372

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	MRS. LETICIA A CANTU
Credential	:
Telephone Number	:	210-733-1802

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	08/22/2020

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