1083951529 NPI number — WESTOVER HILLS LUNG CENTER

Table of content: (NPI 1083951529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083951529 NPI number — WESTOVER HILLS LUNG CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTOVER HILLS LUNG CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083951529
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/20/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10004 WURZBACH RD
Provider Second Line Business Mailing Address:
SUITE 301
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78230-2214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-370-2333
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3303 ROGERS ROAD
Provider Second Line Business Practice Location Address:
ROGERS ROAD MEDICAL PLAZA SUITE 250
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-417-4142
Provider Business Practice Location Address Fax Number:
210-702-3372
Provider Enumeration Date:
01/03/2013

Additional Information

Authorized Official

Authorized Official Last Name:
NALLAGATLA
Authorized Official First Name:
SASIKANTH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
210-370-2333

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  N5273 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 345733501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com