Provider Demographics
NPI:1720104821
Name:EPILEPSY FOUNDATION CENTRAL & SOUTH TEXAS
Entity Type:Organization
Organization Name:EPILEPSY FOUNDATION CENTRAL & SOUTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SINDI
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-653-5353
Mailing Address - Street 1:10615 PERRIN BEITEL RD STE 602
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-3142
Mailing Address - Country:US
Mailing Address - Phone:210-653-5353
Mailing Address - Fax:210-653-5355
Practice Address - Street 1:904 CORPUS CHRISTI ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5277
Practice Address - Country:US
Practice Address - Phone:210-653-5353
Practice Address - Fax:210-653-5355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0067AKMedicare ID - Type UnspecifiedMEDICARE GROUP ID