Provider Demographics
NPI:1194012344
Name:APSP-SAN ANTONIO, LLC
Entity type:Organization
Organization Name:APSP-SAN ANTONIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-285-2732
Mailing Address - Street 1:8500 VILLAGE DR STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5510
Mailing Address - Country:US
Mailing Address - Phone:866-963-8889
Mailing Address - Fax:866-953-9990
Practice Address - Street 1:2410 W MEMORIAL RD STE C432
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-8047
Practice Address - Country:US
Practice Address - Phone:405-285-2732
Practice Address - Fax:866-953-9990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APNEA SPECIALISTS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory