Organization
ONETWO STARS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MCCLINTOCK (COMPLIANCE OFFICER)
(866) 374-6628
Entity
Organization
Contact information
Practice address
1141 N LOOP 1604 E STE 426, SAN ANTONIO, TX 78232-1339
(866) 374-6628
(866) 951-1120
Mailing address
1141 N LOOP 1604 E STE 426, SAN ANTONIO, TX 78232-1339
(866) 374-6628
(866) 951-1120
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
Other
Enumeration date
04/13/2020
Last updated
04/05/2022
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