Provider Demographics
NPI:1831144351
Name:BERNARD T SWIFT JR DBA TEXAS MEDCLINIC
Entity Type:Organization
Organization Name:BERNARD T SWIFT JR DBA TEXAS MEDCLINIC
Other - Org Name:TEXAS MEDCLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:SWIFT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:210-349-5592
Mailing Address - Street 1:13722 EMBASSY ROW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2000
Mailing Address - Country:US
Mailing Address - Phone:210-349-5592
Mailing Address - Fax:210-349-5628
Practice Address - Street 1:13722 EMBASSY ROW
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-2000
Practice Address - Country:US
Practice Address - Phone:830-606-5533
Practice Address - Fax:830-606-5535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00RM46Medicare ID - Type UnspecifiedMEDICARE GROUP ID