Provider Demographics
NPI:1982795316
Name:SOUTHWEST GENETICS, P.A.
Entity Type:Organization
Organization Name:SOUTHWEST GENETICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHODR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-615-8237
Mailing Address - Street 1:7614 LOUIS PASTEUR DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4036
Mailing Address - Country:US
Mailing Address - Phone:210-615-8237
Mailing Address - Fax:210-615-8239
Practice Address - Street 1:7614 LOUIS PASTEUR DR
Practice Address - Street 2:SUITE 310
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4036
Practice Address - Country:US
Practice Address - Phone:210-615-8237
Practice Address - Fax:210-615-8239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Multi-Specialty
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00L24BMedicare ID - Type Unspecified