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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA RODRIGUEZ HOLGUIN (DIRECTOR)
(210) 977-9555
Entity
Organization

Contact information

Practice address
916 SIMS AVE, SAN ANTONIO, TX 78225-2366
(210) 977-9555
(210) 977-9992
Mailing address
916 SIMS AVE, SAN ANTONIO, TX 78225-2366
(210) 977-9555
(210) 977-9992

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary

Other

Enumeration date
02/19/2007
Last updated
08/22/2020
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