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Organization
SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC
Active
Organization
SAN ANTONIO INTERNAL MEDICINE PHYSICIANS, PLLC
Active
Other names
IMED Healthcare Associates
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA S. CLOUD (VICE PRESIDENT)
(210) 575-8501
Entity
Organization
Contact information
Practice address
255 E SONTERRA BLVD, SUITE 100, SAN ANTONIO, TX 78258-4075
(210) 404-0000
(210) 404-2813
Mailing address
8109 FREDERICKSBURG RD, PHYSICIAN PRACTICE SERVICES, SAN ANTONIO, TX 78229-3311
(210) 575-8501
(210) 575-0167
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0097WM
BCBS
TX
05
—
2167660-01
—
TX
Enumeration date
04/12/2011
Last updated
07/27/2011
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