Provider Demographics
NPI:1356000970
Name:CONTINUUM PROVIDER GROUP LLC
Entity Type:Organization
Organization Name:CONTINUUM PROVIDER GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NSIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:210-480-1219
Mailing Address - Street 1:6200 UTSA BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1618
Mailing Address - Country:US
Mailing Address - Phone:210-480-1219
Mailing Address - Fax:
Practice Address - Street 1:6200 UTSA BLVD STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1618
Practice Address - Country:US
Practice Address - Phone:210-480-1219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty