Provider Demographics
NPI:1831919612
Name:SPINE CARE & PAIN MANAGEMENT OF SAN ANTONIO LLC
Entity type:Organization
Organization Name:SPINE CARE & PAIN MANAGEMENT OF SAN ANTONIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:C
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:726-203-4561
Mailing Address - Street 1:20079 STONE OAK PKWY STE 1245
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-6957
Mailing Address - Country:US
Mailing Address - Phone:726-203-4561
Mailing Address - Fax:
Practice Address - Street 1:9130 WURZBACH RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1070
Practice Address - Country:US
Practice Address - Phone:210-545-0087
Practice Address - Fax:210-545-3455
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPINE CARE & PAIN MANAGEMENT OF SAN ANTOINO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty