MEDICARE: VMD PRIMARY PROVIDERS SOUTH HILL COUNTRY TEXAS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207R00000X	Internal Medicine Physician
2	363A00000X	Physician Assistant
3	363L00000X	Nurse Practitioner
4	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1902400880
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VMD PRIMARY PROVIDERS SOUTH HILL COUNTRY TEXAS, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 360569
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-6569
Country	:	US
Telephone Number	:	210-436-8400
Fax Number	:	833-452-1052

Provider Business Practice Location Address
First Line	:	1581 AUSTIN HWY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-1848
Country	:	US
Telephone Number	:	210-436-8400
Fax Number	:	833-452-1052

Authorized Official
Title or Position	:	DIRECTOR REVENUE CYCLE
Name	:	REBECCA RAGER
Credential	:
Telephone Number	:	844-969-0686

Provider Enumeration Date	:	11/23/2020
Last Update Date	:	07/25/2025

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