Provider Demographics
NPI:1386117224
Name:HEALTHCHOICE MEDICAL GROUP
Entity type:Organization
Organization Name:HEALTHCHOICE MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAYANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-331-4270
Mailing Address - Street 1:12446 WEST AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2530
Mailing Address - Country:US
Mailing Address - Phone:830-331-4270
Mailing Address - Fax:830-331-4218
Practice Address - Street 1:136 OLD SAN ANTONIO RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3337
Practice Address - Country:US
Practice Address - Phone:210-525-1668
Practice Address - Fax:210-525-1669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty