Organization
UNIVERSITY OF THE INCARNATE WORD
Active
Other names
University of the Incarnate Word Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
BJ LOUGH (ASSOCIATE ATHLETIC DIR SPORT MED)
(210) 283-6481
Entity
Organization
Contact information
Practice address
4301 BROADWAY ST # 288, SAN ANTONIO, TX 78209-6318
(210) 283-6481
(210) 634-1252
Mailing address
4301 BROADWAY ST # 288, SAN ANTONIO, TX 78209-6318
(210) 283-6481
(210) 634-1252
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
11/02/2015
Last updated
10/02/2018
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