Organization
SAN ANTONIO EXTENDED MEDICAL CARE, INC.
Active
Other names
Med Mart
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS BARRERA (PRESIDENT)
(210) 697-9933
Entity
Organization
Contact information
Practice address
1080 CROWN RIDGE BLVD STE 1, EAGLE PASS, TX 78852-3496
(830) 757-4416
(830) 757-5550
Mailing address
21195 W INTERSTATE 10 STE 1101, SAN ANTONIO, TX 78257-1675
(210) 697-9933
(210) 697-8753
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1025668
ACM
TX
05
—
173462601
—
TX
05
—
173462602
—
TX
01
—
532247
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/08/2006
Last updated
01/10/2024
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