Organization
SAN ANTONIO SPINE SURGERY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YVONNE LOPEZ (CREDENTIALING COORDINATOR)
(210) 615-8292
Entity
Organization
Contact information
Practice address
12501 JUDSON RD, STE 201, LIVE OAK, TX 78233-4103
(210) 615-8292
(210) 615-8297
Mailing address
8255 FREDERICKSBURG RD, SAN ANTONIO, TX 78229-3357
(210) 615-8292
(210) 615-8297
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
M9701
TX
Other
Enumeration date
08/11/2008
Last updated
10/13/2008
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