Provider Demographics
NPI:1639596216
Name:SAN ANTONIO HEALTHCARE CENTER LLC
Entity Type:Organization
Organization Name:SAN ANTONIO HEALTHCARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THIMIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTALAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC, FNP
Authorized Official - Phone:210-347-9864
Mailing Address - Street 1:303 E QUINCY ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1918
Mailing Address - Country:US
Mailing Address - Phone:210-229-7242
Mailing Address - Fax:210-227-5092
Practice Address - Street 1:303 E QUINCY ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1918
Practice Address - Country:US
Practice Address - Phone:210-229-7242
Practice Address - Fax:210-227-5092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7412111NN0400X
TX777944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty