# TRUSTED CARE SAN ANTONIO NW LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811419880
- **Authorized official:** WAYNE DESTEFANO (MANAGER)
- **Authorized official phone:** (602) 715-1654

## Contact information

- **Practice address:** 2116 BABCOCK RD, SAN ANTONIO, TX 78229-4411
- **Practice address phone:** (602) 715-1654
- **Practice address fax:** (602) 715-1654
- **Mailing address:** 20430 N 19TH AVE STE B145, PHOENIX, AZ 85027-3588
- **Mailing address phone:** (210) 202-0288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/12/2017
- **Last updated:** 11/17/2017