Provider Demographics
NPI:1336166271
Name:SOUTH WEST TEXAS BONE & JOINT INSTITUTE
Entity Type:Organization
Organization Name:SOUTH WEST TEXAS BONE & JOINT INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LINDSEY
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-775-3553
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78292-0307
Mailing Address - Country:US
Mailing Address - Phone:830-775-3553
Mailing Address - Fax:210-541-0438
Practice Address - Street 1:1011 E 7TH ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4162
Practice Address - Country:US
Practice Address - Phone:830-775-3553
Practice Address - Fax:210-541-0438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty