Provider Demographics
NPI:1831464155
Name:SOUTH TEXAS ORTHOPEDIC ASSISTANTS
Entity Type:Organization
Organization Name:SOUTH TEXAS ORTHOPEDIC ASSISTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:PHELPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-545-7171
Mailing Address - Street 1:1139 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4347
Mailing Address - Country:US
Mailing Address - Phone:210-545-7171
Mailing Address - Fax:210-545-7176
Practice Address - Street 1:1139 E SONTERRA BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4347
Practice Address - Country:US
Practice Address - Phone:210-545-7171
Practice Address - Fax:210-545-7176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty