Third Coast Emergency Physicians Southwest PA
Organization Active NPI Emergency Medicine Physician · San Antonio, TX
NPI 1497793475 · NPPES record last updated Oct 10, 2019
Key facts
- NPI
- 1497793475
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- THIRD COAST EMERGENCY PHYSICIANS SOUTHWEST PA
- Practice address
- 4103 North Look 1604 W
San Antonio, TX 78249-1395 - Phone
- (330) 493-4443
- NPI assigned
- Jun 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Sam Roberts, MD
- Title
- President
- Phone
- (512) 452-8533
Practitioners 417
-
Nadia Badillo Ayala, P.A.-C
-
Bo Guan, MD
-
Matthew Michael Hessel, M.D.
-
Alicia Marie Higgins, PA-C
-
Carri Rae Oubre, M.D.
-
Robert O Rollo, MD
-
Amy Elizabeth Glover, PA-C
-
David Gonzalez, M.D.
-
Angela Joyce Hladik, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031222000126 | TX | Part B Supplier - Clinic/Group Practice | 6800794447 |
Receives reassigned benefits from 417 practitioners Practice locations: San Antonio, TX; Schertz, TX; Lakeway, TX |
National Provider Directory
Locations
6300 La Calma Dr
Ste 101
Austin, TX 78752
16088 San Pedro Ave
San Antonio, TX 78232
Phone (210) 402-4092
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
4103 North Look 1604 W
San Antonio, TX 78249-1395
Mailing address
4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (330) 493-4443
Other providers in San Antonio, TX
- Thilo E. Burzlaff, M.D. P.a.
- Thimios D. Partalas DC PA
- Thimios D. Partalas, D.C., P.a.
- Giselle Thirakul
- Tarone Thirawatananond
- Third Coast Surgical Services, LLP
- Third Day Counseling Services, PLLC
- Third Space Counseling and Consultation, PLLC
- Thirteen Lac Inc.
- Thanvi Madhusri Thodati
All providers in San Antonio, TX · Emergency Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.