Organization
SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA
Active
Parent organization
SPORTS MEDICINE ASSOCIATES SAN
Other names
Center For Physical Therapy and Sports Perform
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPORTS MEDICINE ASSOCIATES SAN
Authorized official
MONICA L MAZONE (CREDENTIALING SPECIALIST)
(210) 340-1479
Entity
Organization
Contact information
Practice address
21 SPURS LANE, STE 340, SAN ANTONIO, TX 78240-1680
(210) 798-8585
(210) 798-8580
Mailing address
21 SPURS LANE, STE 300, SAN ANTONIO, TX 78240-1679
(210) 699-8326
(210) 561-7121
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164423902
—
TX
Enumeration date
01/05/2007
Last updated
09/30/2024
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