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Organization

KIDNEY AND BLOOD PRESSURE CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. JESSICA J MEDOLA (SUPERVISOR)
(210) 692-1515
Entity
Organization

Contact information

Practice address
3939 MEDICAL DR, STE 110, SAN ANTONIO, TX 78229-2292
(210) 692-1515
(210) 692-0187
Mailing address
3939 MEDICAL DR, STE 110, SAN ANTONIO, TX 78229-2292
(210) 692-1515
(210) 692-0187

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
F1406
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00GT38
BC/BS
TX
05
0828279-01
TX
Enumeration date
06/08/2005
Last updated
03/26/2008
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