Organization · Type 2 NPI

University of the Incarnate Word

Orthopaedic Surgery Physician · San Antonio, TX

NPI number 1780057513 Active

Practice location

4301 Broadway St # 288
San Antonio, TX 78209-6318

Fax (210) 634-1252

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Orthopaedic Surgery Physician Primary	207X00000X	None listed
Sports Medicine (Orthopaedic Surgery) Physician	207XX0005X	None listed

Orthopaedic Surgery Physician: An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformitie…

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NPI record

NPI: 1780057513
Entity type: Organization (Type 2)
Issued: Nov 2, 2015
Last updated: Oct 2, 2018
Status: Active

Other names

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University of the Incarnate Word Sports Medicine · doing business as
University of the Incarnate Word Sports Medicine · doing business as

Authorized official

BJ Lough
Associate Athletic Dir Sport Med
(210) 283-6481

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1780057513

University of the Incarnate Word's National Provider Identifier is 1780057513, issued on Nov 2, 2015. The primary taxonomy on file is Orthopaedic Surgery Physician (207X00000X), and the practice location is in San Antonio, TX. The record was last updated on Oct 2, 2018.