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Organization

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Organization subpart
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Provider details

NPI number
Authorized official
JASON GEROIANNI (EXECUTIVE DIRECTOR)
(210) 877-2228
Entity
Organization

Contact information

Practice address
12001 NETWORK BLVD, SUITE 314, SAN ANTONIO, TX 78249-3351
(210) 877-2228
(210) 877-2235
Mailing address
12001 NETWORK BLVD, SUITE 314, SAN ANTONIO, TX 78249-3351
(210) 877-2228
(210) 877-2235

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
17053267341058
TX

Other

Enumeration date
01/20/2010
Last updated
01/23/2012
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