| NPI Details | |
|---|---|
| NPI | 1174921803 |
| Enumeration Date | 12/11/2014 |
| Last Updated | 06/23/2015 |
| Entity Type | Healthcare Provider |
| Active | Over 2 years ago |
| Authorized Information | |
|---|---|
| Name | JON JON |
| Position | CEO |
| Phone | (210) 493-8378 |
| Fax | (210) 408-0722 |
| Practice Location | |
|---|---|
| 15733 SAN PEDRO AVE SAN ANTONIO TX, 78232-3726, US |
|
| Phone | (210) 493-8378 |
| Fax | (210) 408-0722 |
| Business Location | |
|---|---|
| 15733 SAN PEDRO AVE SAN ANTONIO TX, 78232-3726, US |
|
| Phone | (210) 493-8378 |
| Fax | (210) 408-0722 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 3336M0002X |
| License State | |
| License Number | |
| Remove 1174921803 NPI Number | |
According to our database, One Source Medical Group Llc NPI is 1174921803, taxonomy code is 3336M0002X One Source Medical Group Llc physically located at 15733 San Pedro Ave, San Antonio TX, 78232-3726. NPI Number 1033115704 has the healthcare provider type.
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1174921803 NPI number is provided on an as is basis without warranty of any kind. 1174921803 is maintained by the National Plan & Provider Enumeration System. The contents of One Source Medical Group Llc are for informational purposes only.
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