Provider Demographics
NPI:1609399096
Name:METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD. L.L.P.
Entity Type:Organization
Organization Name:METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD. L.L.P.
Other - Org Name:METHODIST SPECIALTY AND TRANSPLANT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-575-8439
Mailing Address - Street 1:8026 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3915
Mailing Address - Country:US
Mailing Address - Phone:210-575-8110
Mailing Address - Fax:210-692-8123
Practice Address - Street 1:8026 FLOYD CURL DRIVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3949
Practice Address - Country:US
Practice Address - Phone:210-575-8110
Practice Address - Fax:210-692-8123
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD. L.L.P.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094154402Medicaid