Basic Information
| Provider Information | |||||||||
| NPI: | 1750406294 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEALTHWORKS MEDGROUP OF SAN ANTONIO, INC. | ||||||||
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| OtherOrganizationName: | TOYOTA FAMILY MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 40 BURTON HILLS BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372156155 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6155651733 | ||||||||
| FaxNumber: | 6152960151 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 LONE STAR PASS | ||||||||
| Address2: | BLDG 46 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782643638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102635700 | ||||||||
| FaxNumber: | 2102635701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | WILLIAMS | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PC OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2102635700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | X | 193200000X MULTI-SPECIALTY GROUP | Dental Providers | Dentist | 152W00000X | X | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | 207Q00000X | X | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 225100000X | X | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.