JEFFERSON FAMILY PRACTICE NPI 1417991035

NPI Information

JEFFERSON FAMILY PRACTICE is a health service clinic center in San Antonio, TX. JEFFERSON FAMILY PRACTICE NPI is 1417991035. The provider is registered as an organization entity type.

The provider's business location address is:

9647 HUEBNER RD
SAN ANTONIO, TX
ZIP 78240-512
Phone: (210) 735-5225
Fax: (210) 735-3207

The provider's authorized official is Kimberly K Heller .
The authorized official title is President and has the following contact phone number (210) 735-1199.

The CLIA number assigned to this NPI record is 45D0501119 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/15/2006 and was last updated on 3/27/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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