Provider Demographics
NPI:1316401250
Name:NIX PHYSICIANS INC.
Entity Type:Organization
Organization Name:NIX PHYSICIANS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL LEGAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-943-4500
Mailing Address - Street 1:414 NAVARRO ST STE 1401
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2534
Mailing Address - Country:US
Mailing Address - Phone:210-579-3520
Mailing Address - Fax:
Practice Address - Street 1:5307 BROADWAY ST STE 130
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5724
Practice Address - Country:US
Practice Address - Phone:210-579-3624
Practice Address - Fax:210-579-3789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty