Provider Demographics
NPI:1225560451
Name:STSSH PHYSICIANS ORGANIZATION
Entity type:Organization
Organization Name:STSSH PHYSICIANS ORGANIZATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAWITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-507-4091
Mailing Address - Street 1:18600 HARDY OAK BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4206
Mailing Address - Country:US
Mailing Address - Phone:210-507-4170
Mailing Address - Fax:210-579-7388
Practice Address - Street 1:18600 HARDY OAK BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4206
Practice Address - Country:US
Practice Address - Phone:210-507-4170
Practice Address - Fax:210-579-7388
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHOPEDIC & SPINE SURGICAL HOSPITAL OF SOUTH TEXAS, L.P.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007868207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty