| NPI | 1396791570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS B. DAVENPORT Administrator 210-237-4492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology |
| 208100000X Physical Medicine & Rehabilitation | |
| 224P00000X Prosthetist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 208600000X Surgery | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2023-07-21 |