Provider Demographics
NPI:1861601858
Name:FAMILY CARE & MINOR EMERGENCY CENTER, P.A.
Entity type:Organization
Organization Name:FAMILY CARE & MINOR EMERGENCY CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGDALENA
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRAUDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-654-4066
Mailing Address - Street 1:1202 E SONTERRA BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4842
Mailing Address - Country:US
Mailing Address - Phone:210-654-4066
Mailing Address - Fax:210-654-9134
Practice Address - Street 1:1202 E SONTERRA BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4842
Practice Address - Country:US
Practice Address - Phone:210-654-4066
Practice Address - Fax:210-654-9134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7924207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00336TOtherMEDICARE GROUP
TX150708901Medicaid
TX00336TOtherMEDICARE GROUP