Organization
NANCY A LOGAN, PHD. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ANN HILDEBRAND (OFFICE MANAGER)
(210) 615-0555
Entity
Organization
Contact information
Practice address
24123 BOERNE STAGE RD, SUITE 430, SAN ANTONIO, TX 78255-9403
(210) 615-0555
(210) 687-1100
Mailing address
24123 BOERNE STAGE RD, SUITE 430, SAN ANTONIO, TX 78255-9403
(210) 615-0555
(210) 687-1100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
23696
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G66C
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/08/2008
Last updated
10/02/2008
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