Provider Demographics
NPI:1780885103
Name:SOUTH TEXAS VETERANS ADMINISTRATION
Entity type:Organization
Organization Name:SOUTH TEXAS VETERANS ADMINISTRATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINITRATIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIER
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:210-483-5791
Mailing Address - Street 1:8611 SHALLOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-4022
Mailing Address - Country:US
Mailing Address - Phone:210-656-3211
Mailing Address - Fax:
Practice Address - Street 1:17440 HENDERSON PASS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232
Practice Address - Country:US
Practice Address - Phone:210-483-5997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNARRT0553492471N0900X
TX40422471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Multi-Specialty