Provider Demographics
NPI:1972830354
Name:SAN ANTONIO ORTHOPAEDIC GROUP, LLP
Entity Type:Organization
Organization Name:SAN ANTONIO ORTHOPAEDIC GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-804-5400
Mailing Address - Street 1:400 CONCORD PLAZA DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6905
Mailing Address - Country:US
Mailing Address - Phone:210-804-5400
Mailing Address - Fax:210-678-4138
Practice Address - Street 1:5000 BAPTIST HEALTH DR
Practice Address - Street 2:SUITE 116
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1193
Practice Address - Country:US
Practice Address - Phone:210-804-5400
Practice Address - Fax:210-678-4138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0005GWOtherBCBS TX
TX145160102Medicaid
TX00594RMedicare PIN