Provider Demographics
NPI:1659525236
Name:METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP
Entity Type:Organization
Organization Name:METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP
Other - Org Name:METHODIST HOSPITAL STONE OAK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRUFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-638-2120
Mailing Address - Street 1:1139 E. SONTERRA BLVD.
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3999
Mailing Address - Country:US
Mailing Address - Phone:210-638-2100
Mailing Address - Fax:210-495-5965
Practice Address - Street 1:1139 E. SONTERRA BLVD.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3999
Practice Address - Country:US
Practice Address - Phone:210-638-2100
Practice Address - Fax:210-495-5965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204254101Medicaid
TX204254101Medicaid