Organization
ELAN ELITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUADALUPE MENDEZ (PRESIDENT)
(210) 614-7074
Entity
Organization
Contact information
Practice address
14603 HUEBNER RD STE 28101, SAN ANTONIO, TX 78230-5469
(210) 614-7074
Mailing address
14603 HUEBNER RD STE 28101, SAN ANTONIO, TX 78230-5469
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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