Provider Demographics
NPI:1417016361
Name:SAN ANTONIO FIRST CHOICE MEDICAL
Entity Type:Organization
Organization Name:SAN ANTONIO FIRST CHOICE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOLMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-340-5383
Mailing Address - Street 1:11411 RENDEZVOUS STE206
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3316
Mailing Address - Country:US
Mailing Address - Phone:210-340-5383
Mailing Address - Fax:210-340-5475
Practice Address - Street 1:11411 RENDEZVOUS STE206
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3316
Practice Address - Country:US
Practice Address - Phone:210-340-5383
Practice Address - Fax:210-340-5475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0054080332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5071030001Medicare ID - Type Unspecified