1699809897 NPI number — PULMONARY & SLEEP ASSOCIATES OF SAN ANTONIO PA

Table of content: (NPI 1699809897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699809897 NPI number — PULMONARY & SLEEP ASSOCIATES OF SAN ANTONIO PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PULMONARY & SLEEP ASSOCIATES OF SAN ANTONIO PA
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:
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:
1699809897
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2338
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
UNIVERSAL CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78148-1338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-599-1433
Provider Business Mailing Address Fax Number:
210-599-1803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11901 TOEPPERWEIN RD
Provider Second Line Business Practice Location Address:
SUITE 1401
Provider Business Practice Location Address City Name:
LIVE OAK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78233-3160
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-599-1433
Provider Business Practice Location Address Fax Number:
210-599-1803
Provider Enumeration Date:
03/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
QURESHI
Authorized Official First Name:
MOHAMMED
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
210-599-1433

Provider Taxonomy Codes

  • Taxonomy code: 207RC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00915Z . This is a "MCR GROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 17460750 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 174607501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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