Organization
INDEPENDENT MEDICAL ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA V GOMEZ (OFFICE MGR)
(210) 614-3335
Entity
Organization
Contact information
Practice address
2829 BABCOCK RD, SUITE 110, SAN ANTONIO, TX 78229-6028
(210) 614-5855
(210) 614-6240
Mailing address
2829 BABCOCK RD, SUITE 110, SAN ANTONIO, TX 78229-6028
(210) 614-5855
(210) 614-6240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F8582
TX
207RP1001X
Pulmonary Disease Physician
E5204
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U59Q
TX BC/BS GRP#
TX
05
—
085706201
—
TX
Enumeration date
11/07/2005
Last updated
12/07/2009
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