Basic Information
| Provider Information | |||||||||
| NPI: | 1154616217 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNICARE HEALTH CENTERS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3066 E COMMERCE ST | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782201013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102337000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2810 DACY LN | ||||||||
| Address2: | |||||||||
| City: | KYLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786406322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122688920 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2011 | ||||||||
| LastUpdateDate: | 06/16/2011 | ||||||||
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| AuthorizedOfficialLastName: | NGUYEN | ||||||||
| AuthorizedOfficialFirstName: | SON | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2102337000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2300X | 717522 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.