# NPI 1912760992

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

## Provider details

- **NPI number:** 1912760992
- **Authorized official:** JORGE SAUCEDO (ACCOUNTANT)
- **Authorized official phone:** (210) 259-7624

## Contact information

- **Practice address:** 14603 HUEBNER RD BLDG 2, SAN ANTONIO, TX 78230-5471
- **Practice address phone:** (210) 259-7624
- **Mailing address:** 1919 OAKWELL FARMS PKWY STE 170, SAN ANTONIO, TX 78218-1856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2024
- **Last updated:** 02/02/2024