Provider Demographics
NPI:1508993981
Name:BEXAR COUNTY HOSPITAL DISTRICT - EASTSIDE
Entity Type:Organization
Organization Name:BEXAR COUNTY HOSPITAL DISTRICT - EASTSIDE
Other - Org Name:UNIVERSITY HEALTH SYSTEM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-358-2101
Mailing Address - Street 1:4502 MEDICAL DR # MS 14-2
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4402
Mailing Address - Country:US
Mailing Address - Phone:210-358-3700
Mailing Address - Fax:210-358-5962
Practice Address - Street 1:210 N RIO GRANDE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78202-3265
Practice Address - Country:US
Practice Address - Phone:210-224-7981
Practice Address - Fax:210-271-0767
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEXAR COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-27
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126881508Medicaid