Provider Demographics
NPI:1861730939
Name:FAMILY HEALTH OF SOUTH TEXAS, PA
Entity type:Organization
Organization Name:FAMILY HEALTH OF SOUTH TEXAS, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:I
Authorized Official - Last Name:ESQUIVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-682-9434
Mailing Address - Street 1:4522 FREDERICKSBURG RD STE A5
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-6517
Mailing Address - Country:US
Mailing Address - Phone:210-692-7171
Mailing Address - Fax:210-277-7460
Practice Address - Street 1:4522 FREDERICKSBURG RD STE A5
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-6517
Practice Address - Country:US
Practice Address - Phone:210-692-7171
Practice Address - Fax:210-277-7460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX337495103Medicaid
TX337495101Medicaid