SAN ANTONIO VASCULAR SPECIALISTS CORP (NPI# 1093371163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093371163 |
| Entity Type | Organization |
| Organization Name | SAN ANTONIO VASCULAR SPECIALISTS CORP |
| Other Organization Name | MODERN VASCULAR |
| Practice Address |
9819 Huebner Rd Bldg 4 San Antonio TX 78240-3253 |
| Mailing Address |
26500 Agoura Rd Ste 102-587 Calabasas CA 91302-1952 |
| Practice Telephone | 2107618775 |
| Practice Fax Number | 2105190216 |
| Mailing Telephone | 8188808605 |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2020-10-05 |
| Authorized Official Name | YURY GAMPEL (MANAGER) |
| Authorized Official Telephone | 8182626423 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2471V0106X |
Radiologic Technologist Specialization: Vascular-Interventional Technology |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Modern Vascular | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 718 Lexington Ave, San Antonio, TX 782124768 | 2106407909 | 2109077800 |
| Street Address |
9819 HUEBNER RD BLDG 4 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78240-3253 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013530310 | Micah Johnson | Radiologic Technologist | 9819 Huebner Rd Bldg 4, San Antonio, TX 78240-3253 | 2020-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184285587 | Vipulkumar P Prajapati | Pathology | 7323 Snowden Rd Apt 3206, San Antonio, TX 78240 | 2019-06-26 |
| 1306406202 | Gabrielle Nicole Sepulveda | Audiologist | 21 Spurs Ln Ste 100, San Antonio, TX 78240 | 2019-06-13 |
| 1457919714 | Mbg Management Group LLC | Hospice Care, Community Based | 5460 Babcock Rd., Ste. 120, San Antonio, TX 78240 | 2019-06-03 |
| 1386117901 | Kevin M Miles | Counselor | 4820 Gus Eckert, #510, San Antonio, TX 78240 | 2019-01-07 |
| 1578046926 | Hubert Velasco | Physical Therapist | 5000 Fawn Meadow Lane, San Antonio, TX 78240 | 2018-09-12 |
| 1740767540 | Sunshine Pharmacy LLC | Pharmacy | 8840 Huebner Rd, San Antonio, TX 78240 | 2018-07-24 |
| 1982193132 | Fitch Surgical Assisting Group, LLC | Specialist/Technologist, Other | 6163 John Chapman, San Antonio, TX 78240 | 2018-05-03 |
| 1295243202 | Janice Marie Hennon | Nurse Practitioner | 9910 Huebner Rd., Suite 250, San Antonio, TX 78240 | 2018-01-12 |
| 1891213195 | Celina Paras | Dietitian, Registered | 6234 W. Jolie Ct., San Antonio, TX 78240 | 2017-09-07 |
| 1245757616 | Claudia G Valdez | Occupational Therapy Assistant | 9306 Maverick Pass, San Antonio, TX 78240 | 2017-08-27 |
| Find all providers in zip 78240 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588290340 | Mission Vascular Specialists Corp | Radiology | 718 Lexington Ave Fl 1, San Antonio, TX 78212-4768 | 2020-03-12 |
| 1407850209 | John Hogg | Radiology | 622 Isom Rd, San Antonio, TX 78216 | 2005-06-09 |
| 1508498072 | Interventional Partners LLC | Radiology | 19016 Stone Oak Pkwy Ste 180, San Antonio, TX 78258-3281 | 2020-02-12 |
| 1508120296 | Courtney Jayne Cook | Radiology | 333 N Santa Rosa St, San Antonio, TX 78207 | 2012-06-27 |
| 1124256755 | Andres Eugenio Garza Berlanga | Radiology | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2009-06-22 |
| 1477780344 | John Allen Walker Jr. | Radiology | 4502 Medical Dr, San Antonio, TX 78229-4402 | 2009-06-17 |
| 1053575415 | Vpa of Texas, Pllc | Radiology | 3201 Cherry Ridge St, San Antonio, TX 78230-4823 | 2008-07-15 |
| 1720116056 | Ghazwan Mohammad Faozi Kroma | Radiology | 7703 Floyd Curl Drive, Radiology, Univ Texas Health Science Center, San Antonio, TX 78229 | 2007-02-28 |
| 1134262660 | Steven A Wagers Jr. | Radiology | 3551 Roger Brooke Drive, Brooke Army Medical Center, San Antonio, TX 78219 | 2007-02-15 |
| 1225091952 | Jorge E Lopera | Radiology | 7703 Floyd Curl Dr, Mail Code 7800, San Antonio, TX 78229-3901 | 2006-04-12 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78240 |
Please comment or provide details below to improve the information on SAN ANTONIO VASCULAR SPECIALISTS CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.