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Organization
SOUTH TEXAS KETAMINE PHYSICIANS PLLC
Active
Organization
SOUTH TEXAS KETAMINE PHYSICIANS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENNESSEE BAILEY MD (CEO)
(210) 259-6682
Entity
Organization
Contact information
Practice address
4334 N LOOP 1604 W # 221, SAN ANTONIO, TX 78249-3484
(210) 259-6682
Mailing address
1150 N LOOP 1604 W STE 108, SAN ANTONIO, TX 78248-4504
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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