Organization
QUALITY CARE MEDICAL GROUP, P.A.
Active
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
Update your record
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