Organization
STEVEN W FATH MD
Active
Other names
GUADALUPE VALLEY SURGICAL ASSOC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LETICIA CANTU (BILLING MANAGER)
(210) 733-1802
Entity
Organization
Contact information
Practice address
1346 E WALNUT ST, SEGUIN, TX 78155-5126
(830) 303-8600
(830) 303-8601
Mailing address
1346 E WALNUT ST, SEGUIN, TX 78155-5126
(830) 303-8600
(830) 303-8601
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K8144
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048HZ
BLUE CROSS
TX
Enumeration date
06/17/2008
Last updated
06/17/2008
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