Organization
VICKI J SPARKS, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICKI JEAN SPARKS MD (OWNER)
(210) 340-2707
Entity
Organization
Contact information
Practice address
114 SOUTHBRIDGE ST, SUITE D, SAN ANTONIO, TX 78216-6264
(210) 340-2707
(210) 340-2746
Mailing address
114 SOUTHBRIDGE ST, SUITE D, SAN ANTONIO, TX 78216-6264
(210) 340-2707
(210) 340-2746
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
E6215
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139217710
—
TX
Enumeration date
09/18/2013
Last updated
09/18/2013
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