Provider Demographics
NPI:1891958542
Name:SAN ANTONIO PREMIER INTERNAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:SAN ANTONIO PREMIER INTERNAL MEDICINE, PLLC
Other - Org Name:SA PREMIER IM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AYHAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:SHNEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-447-3033
Mailing Address - Street 1:1032 S WW WHITE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-2531
Mailing Address - Country:US
Mailing Address - Phone:210-447-3033
Mailing Address - Fax:210-447-3036
Practice Address - Street 1:1032 S WW WHITE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78220-2531
Practice Address - Country:US
Practice Address - Phone:210-447-3033
Practice Address - Fax:210-447-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0098RTOtherBCBS
TX202478801Medicaid
TX00Z912Medicare PIN