Provider Demographics
NPI:1730453226
Name:RIVER ACRES MEDICAL GROUP, PA
Entity type:Organization
Organization Name:RIVER ACRES MEDICAL GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:BARTAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-620-0956
Mailing Address - Street 1:1260 RIVER ACRES DR
Mailing Address - Street 2:STE 1
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3689
Mailing Address - Country:US
Mailing Address - Phone:830-620-0956
Mailing Address - Fax:830-620-0286
Practice Address - Street 1:1260 RIVER ACRES DR
Practice Address - Street 2:STE 1
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3689
Practice Address - Country:US
Practice Address - Phone:830-620-0956
Practice Address - Fax:830-620-0286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty