Basic Information
| Provider Information | |||||||||
| NPI: | 1306162920 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SOUTH TEXAS AMBULATORY SURGERY CENTER, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9238 FLOYD CURL DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782401690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105586234 | ||||||||
| FaxNumber: | 2106151840 | ||||||||
| Practice Location | |||||||||
| Address1: | 9238 FLOYD CURL DR | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782401690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105586234 | ||||||||
| FaxNumber: | 2106151840 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2010 | ||||||||
| LastUpdateDate: | 04/08/2010 | ||||||||
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| AuthorizedOfficialLastName: | O'QUINN | ||||||||
| AuthorizedOfficialFirstName: | RYAN | ||||||||
| AuthorizedOfficialMiddleName: | PATRICK | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2105586234 | ||||||||
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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 | 261QA1903X | PENDING | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.