Provider Demographics
NPI:1497825756
Name:HOFFMAN, GREGORY SCOTT
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:SCOTT
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 N LOOP 1604 E # 105-446
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1339
Mailing Address - Country:US
Mailing Address - Phone:210-598-2801
Mailing Address - Fax:210-566-1330
Practice Address - Street 1:1141 N LOOP 1604 E # 105-446
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1339
Practice Address - Country:US
Practice Address - Phone:210-598-2801
Practice Address - Fax:210-566-1330
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL 1507Medicare PIN