Organization
EMERGENCY PEDIATRIC PHYSICIAN MGMT LLC
Active
Organization
EMERGENCY PEDIATRIC PHYSICIAN MGMT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES S. POTYKA MD (GENERAL PARTNER)
(210) 495-9860
Entity
Organization
Contact information
Practice address
520 MADISON OAK, PEDS - EMERGENCY ROOM, SAN ANTONIO, TX 78258-3913
(210) 297-4050
Mailing address
8401 DATAPOINT DR, SUITE 500, SAN ANTONIO, TX 78229-5907
(210) 614-0180
(210) 566-2063
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030MS
BCBSTX
TX
05
—
174511901
—
TX
Enumeration date
05/04/2006
Last updated
06/13/2008
Update your record
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