Provider Demographics
NPI:1922368356
Name:SAN ANTONIO TMS, LLC
Entity Type:Organization
Organization Name:SAN ANTONIO TMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:IGNACIO
Authorized Official - Last Name:CAMPOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-380-3107
Mailing Address - Street 1:16019 VIA SHAVANO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2370
Mailing Address - Country:US
Mailing Address - Phone:210-764-0054
Mailing Address - Fax:210-690-8815
Practice Address - Street 1:16019 VIA SHAVANO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2370
Practice Address - Country:US
Practice Address - Phone:210-764-0054
Practice Address - Fax:210-690-8815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8047261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health