Organization
SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA BATCH (ADMINISTRATOR)
(210) 822-8326
Entity
Organization
Contact information
Practice address
5921 BROADWAY ST, SAN ANTONIO, TX 78209-5235
(210) 822-8326
(210) 823-5429
Mailing address
21 SPURS LN, STE 300, SAN ANTONIO, TX 78240-1679
(210) 822-8326
(210) 561-7121
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
TX
208100000X
Physical Medicine & Rehabilitation Physician
—
TX
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0051KV
BCBS
TX
05
—
164423902
—
TX
Enumeration date
08/28/2012
Last updated
09/30/2024
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