Provider Demographics
NPI:1023248754
Name:METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO,LTD,LLP
Entity type:Organization
Organization Name:METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO,LTD,LLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:L
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:210-757-7000
Mailing Address - Street 1:10230 MISSION CRK
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-1680
Mailing Address - Country:US
Mailing Address - Phone:210-592-8254
Mailing Address - Fax:
Practice Address - Street 1:12412 JUDSON RD
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3255
Practice Address - Country:US
Practice Address - Phone:210-757-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METHODIST MINISTRIES OF SAN ANTONIO IN SOUTH TEXAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-15
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX724055313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility