1972557965 NPI number — METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P.

Table of content: (NPI 1972557965)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972557965 NPI number — METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO, LTD., L.L.P.
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:
1972557965
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/03/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12412 JUDSON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVE OAK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78233-3255
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-650-4949
Provider Business Mailing Address Fax Number:
210-646-5038

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12412 JUDSON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVE OAK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78233-3255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-650-4949
Provider Business Practice Location Address Fax Number:
210-646-5038
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEAL
Authorized Official First Name:
CLAUDIA
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
210-646-5000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000046027A . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0524479 . This is a "AETNA/US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3341321 . This is a "HEALTHMARKET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 450733 . This is a "UNICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5000170 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: HH0789 . This is a "BLUE CROSS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 450733 . This is a "STERLING OPTION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 177525700 . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 378662 . This is a "BLACK LUNG" identifier . This identifiers is of the category "OTHER".




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