Individual
DR. JACK C BORDERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-3030
Mailing address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-3342
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
039054
GA
207YP0228X
Pediatric Otolaryngology Physician
Primary
3792
WI
207YP0228X
Pediatric Otolaryngology Physician
U4672
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000617801B
—
GA
05
—
000617801F
—
GA
Enumeration date
04/14/2006
Last updated
03/14/2024
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