Provider Demographics
NPI:1609110923
Name:TRANSITIONCARE MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:TRANSITIONCARE MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:H
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MHA
Authorized Official - Phone:210-404-2650
Mailing Address - Street 1:225 E SONTERRA BLVD
Mailing Address - Street 2:201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3992
Mailing Address - Country:US
Mailing Address - Phone:210-499-0060
Mailing Address - Fax:
Practice Address - Street 1:1202 E SONTERRA BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4089
Practice Address - Country:US
Practice Address - Phone:210-615-6626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRANSITIONCARE HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-27
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty