Organization
TOTAL CARE PAIN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN FOM MD (OWNER)
(563) 564-1283
Entity
Organization
Contact information
Practice address
9026 CULEBRA RD STE 101, SAN ANTONIO, TX 78251-2882
(563) 564-1283
Mailing address
8711 WALES RESERVE, SAN ANTONIO, TX 78255-3371
(563) 564-1283
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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