Organization Name: | STATESERV MEDICAL OF SAN ANTONIO |
NPI Number: | 1063809622 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER ROODE (COO) |
Mailing Address: | 5723 Rittiman Pl San Antonio |
State: | TX US |
Postal Code: | 782185220 |
Phone Number: | 8776337250 |
Fax Number: | |
NPI Enumeration Date: | 04/22/2015 |
NPI Last Update Date: | 04/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | TX32303 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |