MEDICARE: AMBULATORY STRATEGIES PHYSICIAN GROUP

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1801424908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMBULATORY STRATEGIES PHYSICIAN GROUP

Provider Business Mailing Address
First Line	:	919 HIDDEN RDG FL 6
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-3813
Country	:	US
Telephone Number	:	469-282-2172
Fax Number	:

Provider Business Practice Location Address
First Line	:	1659 HIGHWAY 46 W STE 160
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-4746
Country	:	US
Telephone Number	:	830-387-4491
Fax Number	:	830-387-5004

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL GENERALE
Credential	:
Telephone Number	:	469-282-2111

Provider Enumeration Date	:	04/01/2020
Last Update Date	:	04/01/2020

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