Organization
SP UNITED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA BACCARI (MANAGER)
(210) 614-8101
Entity
Organization
Contact information
Practice address
3463 MAGIC DR STE T21, SAN ANTONIO, TX 78229-3621
(210) 614-8101
Mailing address
3463 MAGIC DR STE T21, SAN ANTONIO, TX 78229-3621
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
02/13/2018
Last updated
02/13/2018
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