Organization
GASTROENTEROLOGY CLINIC OF SAN ANTONIO, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL HAVRANEK MD (CEO)
(210) 615-8308
Entity
Organization
Contact information
Practice address
8550 DATAPOINT DR, SUITE 200, SAN ANTONIO, TX 78229-3270
(210) 615-8308
(210) 615-8313
Mailing address
8550 DATAPOINT DR, SUITE 200, SAN ANTONIO, TX 78229-3270
(210) 615-8308
(210) 615-8313
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00BL45
MEDICARE PTAN
TX
05
—
044080201
—
TX
Enumeration date
11/03/2006
Last updated
10/29/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us