Provider Demographics
NPI:1699024190
Name:MEDICAL SPECIALISTS OF SOUTH TEXAS, PA
Entity Type:Organization
Organization Name:MEDICAL SPECIALISTS OF SOUTH TEXAS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-347-9863
Mailing Address - Street 1:2425 BABCOCK RD
Mailing Address - Street 2:STE. 111
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4898
Mailing Address - Country:US
Mailing Address - Phone:210-347-9863
Mailing Address - Fax:
Practice Address - Street 1:2425 BABCOCK RD
Practice Address - Street 2:STE. 111
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4898
Practice Address - Country:US
Practice Address - Phone:210-347-9863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty