Organization
SOBA TEXAS LLC
Active
Other names
Soba Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY GRAHAM (CFO)
(310) 457-5250
Entity
Organization
Contact information
Practice address
1401 DEZARAE, LOT 4, SAN ANTONIO, TX 78253
(210) 530-4167
Mailing address
1401 DEZARAE, LOT 3, SAN ANTONIO, TX 78253-5840
Taxonomy
Speciality
Code
Description
License number
State
2084P0802X
Addiction Psychiatry Physician
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/13/2016
Last updated
09/16/2025
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