Provider Demographics
NPI:1043835036
Name:OVERCOME OPIOID ADDICTION
Entity Type:Organization
Organization Name:OVERCOME OPIOID ADDICTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:210-660-8760
Mailing Address - Street 1:303 W SUNSET RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1744
Mailing Address - Country:US
Mailing Address - Phone:210-660-8760
Mailing Address - Fax:
Practice Address - Street 1:303 W SUNSET RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1749
Practice Address - Country:US
Practice Address - Phone:210-660-8760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty