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Specialty details in registry · San Antonio, TX

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At a glance

2601 Pleasanton Rd Ste 101, San Antonio, TX 78221-1802

NPPES record updated Sep 4, 2015. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

2601 Pleasanton Rd Ste 101
San Antonio, TX 78221-1802
Professional details: NPI, taxonomy & registry record
NPI1730557901
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
302R00000X
Enumeration date
Sep 4, 2015
Record updated
Sep 4, 2015
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

302R00000X · Primary

License reported: 3-2053-0088 TX

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

2601 Pleasanton Rd Ste 101
San Antonio, TX 78221-1802
Phone
(210) 858-9320
Fax
(210) 858-6650
Mailing address
2601 PLEASANTON RD STE 101

SAN ANTONIO, TX 782211802
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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