Provider Demographics
NPI:1043468937
Name:ST. JOHN PARTNERSHIP LTD
Entity Type:Organization
Organization Name:ST. JOHN PARTNERSHIP LTD
Other - Org Name:PECAN VALLEY AMBULATORY SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MINGUEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA
Authorized Official - Phone:210-563-4546
Mailing Address - Street 1:1983 OAKWELL FARMS PKWY
Mailing Address - Street 2:SUITE 704
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-1724
Mailing Address - Country:US
Mailing Address - Phone:210-563-4546
Mailing Address - Fax:
Practice Address - Street 1:1983 OAKWELL FARMS PKWY
Practice Address - Street 2:SUITE 704
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-1724
Practice Address - Country:US
Practice Address - Phone:210-563-4546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008276261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181148101Medicaid