Provider Demographics
NPI:1992796742
Name:SAN ANTONIO ENDOSCOPY, LP
Entity type:Organization
Organization Name:SAN ANTONIO ENDOSCOPY, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-343-9083
Mailing Address - Street 1:8550 DATAPOINT DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3436
Mailing Address - Country:US
Mailing Address - Phone:210-615-7232
Mailing Address - Fax:210-615-6732
Practice Address - Street 1:8550 DATAPOINT DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3436
Practice Address - Country:US
Practice Address - Phone:210-615-7232
Practice Address - Fax:210-615-6732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008225261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH005AOtherTEXAS BCBS
TX1608226-01Medicaid
TX1608226-01Medicaid
TXHH005AOtherTEXAS BCBS
45C0001338Medicare Oscar/Certification