Organization
SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA
Active
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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