Organization
QUALITY CARE MEDICAL GROUP, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNE CALDERA DE LA FUENTE (AUTHORIZED AGENT)
(210) 615-1170
Entity
Organization
Contact information
Practice address
4115 MEDICAL DR, SUITE 500, SAN ANTONIO, TX 78229-5657
(210) 615-1170
(210) 614-6996
Mailing address
4115 MEDICAL DR, SUITE 500, SAN ANTONIO, TX 78229-5657
(210) 615-1170
(210) 614-6996
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0063MG
BLUE CROSS BLUE SHIELD TX
TX
Enumeration date
02/22/2008
Last updated
02/22/2008
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