Organization
LAKE MI MOBILE DOCTORS PC
Active
Organization
LAKE MI MOBILE DOCTORS PC
Active
Other names
Mobile Doctors of San Antonio
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYSYN CONTRERAS (DIRECTOR OF QUALITY ASSURANCE)
(773) 751-7200
Entity
Organization
Contact information
Practice address
3201 CHERRY RIDGE ST, SUITE C-315, SAN ANTONIO, TX 78230-4823
(210) 319-5487
(210) 342-2300
Mailing address
3319 N. ELSTON AVE., SUITE 200, CHICAGO, IL 60618-5811
(773) 751-7200
(773) 583-4401
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
213E00000X
Podiatrist
—
—
Other
Enumeration date
10/26/2012
Last updated
10/26/2012
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