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Organization

METHODIST MEDICAL GROUP, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ROBERTA S CLOUD (VICE PRESIDENT)
(210) 575-8505
Entity
Organization

Contact information

Practice address
8109 FREDERICKSBURG RD, PHYSICIAN PRACTICE SERVICES, SAN ANTONIO, TX 78229-3311
(210) 575-0254
(210) 575-0167
Mailing address
8109 FREDERICKSBURG RD, PHYSICIAN PRACTICE SERVICES, SAN ANTONIO, TX 78229-3311
(210) 575-0254
(210) 575-0167

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
207RC0000X
Cardiovascular Disease Physician
Primary
207RC0001X
Clinical Cardiac Electrophysiology Physician
207RI0011X
Interventional Cardiology Physician

Other

Enumeration date
03/13/2012
Last updated
03/14/2012
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