| NPI | 1306674981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE BIRKELO Credentialing Specialist 210-756-5240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-09-30 |