Organization
MD MEDCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY CORLESS (OWNER)
(210) 669-3730
Entity
Organization
Contact information
Practice address
118 BROADWAY ST STE 607, SAN ANTONIO, TX 78205-1983
(210) 374-4580
Mailing address
118 BROADWAY ST STE 607, SAN ANTONIO, TX 78205-1983
(210) 374-4580
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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