Provider Demographics
NPI:1053533273
Name:SAN ANTONIO ACCIDENT AND REHAB
Entity type:Organization
Organization Name:SAN ANTONIO ACCIDENT AND REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:210-223-9797
Mailing Address - Street 1:1550 NE LOOP 410
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1610
Mailing Address - Country:US
Mailing Address - Phone:210-223-9797
Mailing Address - Fax:210-223-9733
Practice Address - Street 1:1550 NE LOOP 410
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1610
Practice Address - Country:US
Practice Address - Phone:210-223-9797
Practice Address - Fax:210-223-9733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8088111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J5531OtherBLUE CROSS BLUE SHIELD
TX8J5531OtherBLUE CROSS BLUE SHIELD