Provider Demographics
NPI:1669787347
Name:SOUTH CENTRAL TEXAS HEALTHCARE
Entity type:Organization
Organization Name:SOUTH CENTRAL TEXAS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-341-9614
Mailing Address - Street 1:8207 CALLAGHAN RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4735
Mailing Address - Country:US
Mailing Address - Phone:210-336-9370
Mailing Address - Fax:
Practice Address - Street 1:8207 CALLAGHAN RD
Practice Address - Street 2:SUITE 320
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4735
Practice Address - Country:US
Practice Address - Phone:210-336-9370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty