Organization
TEXAS LINCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIDA DASH LMSW-AP (DIRECTOR/MEDICAL CASE MANAGER)
(210) 496-3194
Entity
Organization
Contact information
Practice address
903 EL PAISAJE, SAN ANTONIO, TX 78258-2900
(210) 496-3194
Mailing address
PO BOX 461384, SAN ANTONIO, TX 78246-1384
(210) 496-3194
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179302801
—
TX
Enumeration date
11/13/2007
Last updated
12/04/2007
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