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Individual

DR. VICKI J SPARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
114 SOUTHBRIDGE ST SUITE D, SAN ANTONIO, TX 78216-6200
(210) 340-2707
(210) 340-2746
Mailing address
114 SOUTHBRIDGE ST STE D, SAN ANTONIO, TX 78216-6200
(210) 340-2707
(210) 340-2746

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
E6215
TX
208D00000X
General Practice Physician
Primary
E6215
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
139217710
TX
Enumeration date
09/11/2006
Last updated
10/04/2013
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