Provider Demographics
NPI:1770042152
Name:THE SAN ANTONIO ORTHOPAEDIC GROUP, LLP
Entity type:Organization
Organization Name:THE SAN ANTONIO ORTHOPAEDIC GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:CHLOE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-804-5416
Mailing Address - Street 1:400 CONCORD PLAZA DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6991
Mailing Address - Country:US
Mailing Address - Phone:210-804-5416
Mailing Address - Fax:210-678-4142
Practice Address - Street 1:1422 E GRAYSON ST STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78208-1427
Practice Address - Country:US
Practice Address - Phone:210-804-5400
Practice Address - Fax:210-396-5309
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE SAN ANTONIO ORTHOPAEDIC GROUP, LLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-15
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty