Organization
DIGESTIVE DISEASES CENTER OF SOUTH TEXAS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVI BOTLA M.D. (PRESIDENT)
(210) 253-3422
Entity
Organization
Contact information
Practice address
621 CAMDEN ST, SAN ANTONIO, TX 78215-1612
(210) 253-3422
(210) 227-9833
Mailing address
PO BOX 17650, SAN ANTONIO, TX 78217-0650
(210) 253-3422
(210) 227-9833
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T16Z
BC/BS
TX
05
—
085153702
—
TX
Enumeration date
09/20/2006
Last updated
11/19/2013
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