Provider Demographics
NPI:1619191194
Name:SARA J. APSLEY-AMBRIZ, D.O.
Entity Type:Organization
Organization Name:SARA J. APSLEY-AMBRIZ, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:APSLEYAMBRIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-694-4081
Mailing Address - Street 1:4466 LOCKHILL SELMA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2078
Mailing Address - Country:US
Mailing Address - Phone:210-694-4081
Mailing Address - Fax:210-696-8053
Practice Address - Street 1:4466 LOCKHILL SELMA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2078
Practice Address - Country:US
Practice Address - Phone:210-694-4081
Practice Address - Fax:210-696-8053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4792207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA65298Medicare UPIN
TXD34C89G20Medicare ID - Type Unspecified