Organization
SAN ANTONIO HEAD & NECK SURGICAL ASSOCIATES
Active
Other names
Ear, Nose & Throat Clinics of San Antonio
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY GIBSON (CREDENTIALER)
(210) 616-0283
Entity
Organization
Contact information
Practice address
926 BOOKLYN AVE, SAN ANTONIO, TX 78215-1637
(210) 616-0283
(210) 616-0071
Mailing address
926 BOOKLYN AVE, SAN ANTONIO, TX 78215-1637
(210) 616-0283
(210) 616-0071
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093833403
—
TX
Enumeration date
06/30/2015
Last updated
06/30/2015
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