Organization
LORENCO INC
Active
Other names
Austin Hwy-Village Drive Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAS JURADO LORENZANA M.D. (MEDICAL DIRECTOR)
(210) 828-4404
Entity
Organization
Contact information
Practice address
8530 VILLAGE DR, SAN ANTONIO, TX 78217-5504
(210) 828-4404
(210) 828-4982
Mailing address
8530 VILLAGE DR, SAN ANTONIO, TX 78217-5504
(210) 828-4404
(210) 828-4982
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
E6481
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00FT10
—
TX
01
—
1700867934
NPI
TX
Enumeration date
04/01/2014
Last updated
04/01/2014
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