Provider Demographics
NPI:1447295753
Name:NEUROSURGICAL ASSOCIATES OF SAN ANTONIO, P.A.
Entity type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES OF SAN ANTONIO, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:ARNELL
Authorized Official - Last Name:TEALER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-477-5733
Mailing Address - Street 1:4410 MEDICAL DR
Mailing Address - Street 2:SUITE 610
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6306
Mailing Address - Country:US
Mailing Address - Phone:210-477-5733
Mailing Address - Fax:210-477-5792
Practice Address - Street 1:4410 MEDICAL DR
Practice Address - Street 2:SUITE 610
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6306
Practice Address - Country:US
Practice Address - Phone:210-477-5733
Practice Address - Fax:210-477-5792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083506801Medicaid
TX00K501Medicare ID - Type Unspecified