Organization
VIDAMOR MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRES IBARRA (SECRETARY)
(830) 282-1544
Entity
Organization
Contact information
Practice address
107 REED RD, BOERNE, TX 78006-8605
(210) 393-2111
Mailing address
107 REED RD, BOERNE, TX 78006-8605
(830) 282-1544
(830) 319-9192
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
07/28/2020
Last updated
11/02/2021
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