Provider Demographics
NPI:1447416185
Name:ACACIA OB GYN PROFESSIONAL ASSOCIATION
Entity Type:Organization
Organization Name:ACACIA OB GYN PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER - ACACIA OBGYN
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:F
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-226-7827
Mailing Address - Street 1:PO BOX 830308
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78283-0308
Mailing Address - Country:US
Mailing Address - Phone:210-226-7827
Mailing Address - Fax:210-433-6329
Practice Address - Street 1:700 S ZARZAMORA ST
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-5255
Practice Address - Country:US
Practice Address - Phone:210-226-7827
Practice Address - Fax:210-433-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty