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Organization
SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC
Active
Organization
SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA CLOUD (VICE PRESIDENT)
(210) 575-8501
Entity
Organization
Contact information
Practice address
1303 MCCULLOUGH AVE, SUITE #560, SAN ANTONIO, TX 78212-5609
(210) 223-9617
(210) 568-1910
Mailing address
1303 MCCULLOUGH AVE, SUITE #560, SAN ANTONIO, TX 78212-5609
(210) 223-9617
(210) 568-1910
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0033TQ
BCBS
TX
05
—
2167660-01
—
TX
Enumeration date
06/21/2010
Last updated
07/21/2011
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