# STATESERV MEDICAL OF SAN ANTONIO

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STATESERV MEDICAL, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063809622
- **Legal business name:** STATESERV MEDICAL, LLC
- **Authorized official:** CHRISTOPHER ROODE (COO)
- **Authorized official phone:** (877) 633-7250

## Contact information

- **Practice address:** 4338 TEJASCO DRIVE, SAN ANTONIO, TX 78218
- **Practice address phone:** (877) 633-7250
- **Mailing address:** 1201 S. ALMA SCHOOL ROAD, SUITE 4000, MESA, AZ 85210
- **Mailing address phone:** (336) 227-8030
- **Mailing address fax:** (336) 227-3288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | TX32303 | TX | Yes |

## Other

- **Enumeration date:** 04/22/2015
- **Last updated:** 10/07/2020