Provider Demographics
NPI:1609931088
Name:SAN ANTONIO A THRU Z PEDIATRICS PA
Entity type:Organization
Organization Name:SAN ANTONIO A THRU Z PEDIATRICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:MANJEERA
Authorized Official - Middle Name:
Authorized Official - Last Name:R
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-490-8888
Mailing Address - Street 1:2415 E EVANS RD STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2806
Mailing Address - Country:US
Mailing Address - Phone:210-490-8888
Mailing Address - Fax:210-496-6865
Practice Address - Street 1:2415 E EVANS RD STE 108
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-2806
Practice Address - Country:US
Practice Address - Phone:210-490-8888
Practice Address - Fax:210-496-6865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty