Provider Demographics
NPI:1952590390
Name:WESTOVER HILLS SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:WESTOVER HILLS SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-479-5784
Mailing Address - Street 1:3903 WISEMAN BLVD
Mailing Address - Street 2:STE 304
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4401
Mailing Address - Country:US
Mailing Address - Phone:210-521-1987
Mailing Address - Fax:210-521-1927
Practice Address - Street 1:3903 WISEMAN BLVD
Practice Address - Street 2:STE 304
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4401
Practice Address - Country:US
Practice Address - Phone:210-521-1987
Practice Address - Fax:210-521-1927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8107202K00000X, 208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0052QHOtherBCBSTX
TX0052QHOtherBCBSTX
TXF19625Medicare UPIN