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Contact Information

PHOENIX MEDICAL ASSOCIATES
222 SIDNEY BAKER SOUTH
SUITE 500
KERRVILLE, TX78028-5900
 Phone: 830-895-7675
 Fax: 830-896-3082
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2084A0401X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for PHOENIX MEDICAL ASSOCIATES

NPI Number 1790736239
LBN Legal business name PHOENIX MEDICAL ASSOCIATES
Authorized official ANAND MEHENDALE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/12/2006
Last updated 09/08/2011 - About 15 years ago
Identifiers
TX License # G1112
TX Medicaid 080790101
TX Other 0093CZ BLUE CROSS BLUE SHIELD
TX Other 00564K MEDICARE PTAN
TX Other CJ3940 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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