FOUR SEASONS BREAST FOUNDATION (NPI# 1770756660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770756660 |
| Entity Type | Organization |
| Organization Name | FOUR SEASONS BREAST FOUNDATION |
| Practice Address |
4400 S Piedras Dr Ste 200 San Antonio TX 78228-1223 |
| Mailing Address |
Po Box 100840 San Antonio TX 78201-8840 |
| Practice Telephone | 2109188510 |
| Mailing Telephone | 2109188510 |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2008-04-11 |
| Authorized Official Name | DR. DIANE M ICENOGLE (PRESIDENT) |
| Authorized Official Telephone | 2109188510 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0206X |
Clinic/Center Specialization: Radiology, Mammography |
Ambulatory Health Care Facilities |
| Street Address |
4400 S PIEDRAS DR STE 200 |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78228-1223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770064206 | Isabel Cristina Moreno | Licensed Vocational Nurse | 5419 Shivalik Way, San Antonio, TX 78228 | 2018-08-23 |
| 1053846097 | Miguel Angel Hernandez | Counselor | 3615 Culebra Road, San Antonio, TX 78228 | 2017-04-27 |
| 1841724424 | Amber Fragoso | Specialist/Technologist | 1 Camino Sanata Maria, San Antonio, TX 78228 | 2017-04-20 |
| 1184175937 | John Amundson IIi | Counselor | 4243 E Piedras Dr # 100, San Antonio, TX 78228 | 2016-10-17 |
| 1215487475 | Compassus Op of Texas LLC | Hospice Care, Community Based | 4242 E Piedras Dr, Suite 200, San Antonio, TX 78228 | 2016-10-11 |
| 1407220130 | Jessica Marie Hernandez-benavidez | Counselor | 2939 W. Woodlawn, Buidling 2, San Antonio, TX 78228 | 2015-11-18 |
| 1720494214 | Early Trail Inc | Assisted Living Facility | 322 Early Trail, San Antonio, TX 78228 | 2014-07-07 |
| 1992117717 | R A Alvarado Medical Pllc | Pain Medicine | 4100 E Piedras Dr Ste 165, San Antonio, TX 78228 | 2014-05-28 |
| 1447681606 | Smile Kings Bandera, Pllc | Dentist | 919 Bandera Rd. Ste 101, San Antonio, TX 78228 | 2013-12-12 |
| 1811230345 | Gwendolyn Holland | Registered Nurse | 5310 Arrowhead Dr, San Antonio, TX 78228 | 2013-04-03 |
| Find all providers in zip 78228 | ||||
| Taxonomy Code | 261QR0206X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mammography |
| Definition to come... |
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| 1003210105 | Kingspoint Medical Imaging, Inc | Clinic/Center | 359 East Parkwwod Ave., Friendswood, TX 77546 | 2014-10-17 |
| 1831435965 | Bsa Hospital LLC | Clinic/Center | 1310 Wallace Blvd, Amarillo, TX 79106-1745 | 2012-12-18 |
| 1669731535 | Huntsville Womens Center, Lp | Clinic/Center | 123 B Medical Park Lane, Huntsville, TX 77340-4981 | 2012-05-11 |
| 1922318005 | Touchstone Imaging of Mesquite, Lp | Clinic/Center | 5455 Basswood Blvd., Suite 550, Fort Worth, TX 76137-4478 | 2010-10-07 |
| 1861693301 | Global Imaging LLP | Clinic/Center | 11211 South Highway 6 Ste B, Sugarland, TX 77478 | 2007-05-31 |
| 1568408078 | Coulter Imaging Center LLC | Clinic/Center | 1900 Coulter St, Unit N, Amarillo, TX 79106-1782 | 2006-06-22 |
| 1568444370 | Gail L Burleson | Clinic/Center | 6611 S Rice Ave, Bellaire, TX 77401-4012 | 2005-11-17 |
| 1114374931 | Pink Door Imaging Center LLC | Clinic/Center | 2424 W Holcombe Blvd Ste 102, Houston, TX 77030-1933 | 2016-05-22 |
| 1568898211 | Ura Professional Services Pa | Clinic/Center | 2616 S Loop W, Suite 170, Houston, TX 77054-2662 | 2013-09-25 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANTONIO |
| Zip Code | 78228 |
Please comment or provide details below to improve the information on FOUR SEASONS BREAST FOUNDATION.
| 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.