Organization
MEDI-TRONICS
Active
Other names
Medi- Tronics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY CARDENAS (PRESIDENT)
(210) 785-8112
Entity
Organization
Contact information
Practice address
1717 CAPITOL AVE, SAN ANTONIO, TX 78201-4643
(210) 785-8112
(210) 785-8113
Mailing address
1717 CAPITOL AVE, SAN ANTONIO, TX 78201-4643
(210) 785-8112
(210) 785-8113
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0039917
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014599
ADVANTAGE BY SUPERIOR
TX
05
—
016799101
—
TX
01
—
1414840001
SUPERIOR STAR PLUS
TX
01
—
533568
BLUECROSS BLUESHIELD OF TX
TX
01
—
QMP000003944245
MOLINA HEALTHCARE
TX
Enumeration date
05/23/2007
Last updated
07/03/2013
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