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
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