Provider Demographics
NPI:1689627655
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:METROPOLITAN METHODIST HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-757-2443
Mailing Address - Street 1:1310 MCCULLOUGH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5601
Mailing Address - Country:US
Mailing Address - Phone:210-208-2200
Mailing Address - Fax:210-208-2915
Practice Address - Street 1:1310 MCCULLOUGH AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5601
Practice Address - Country:US
Practice Address - Phone:210-208-2200
Practice Address - Fax:210-208-2915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
000045689OtherHUMANA
0513909OtherAETNA/US HEALTHCARE
310366OtherBLACK LUNG
TXHH0687OtherBLUE CROSS
LA1742376Medicaid
105382900OtherUS DEPT OF LABOR
2594257OtherHEALTHMARKET
450388OtherSTERLING OPTION
0513909OtherAETNA/US HEALTHCARE