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Contact Information

COSTANCE Y STATEN, DIRECTOR
7000 GULFSHORE
SAN ANTONIO, TX78244
 Phone: 210-707-7784
 Fax:
 Website:
Indicates primary specialty

NPI Profile & details for

NPI Number 1588822308
Entity Organization
Organization subpart 1 Not specified
Enumeration date 05/29/2008
Last updated 05/29/2008 - About 18 years ago
Identifiers
TX License # 121763
TX License # 21763
TX Medicaid 51430089
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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