SAN ANGELO (1181)    INSTITUTION (4)

Name Value
NAME SAN ANGELO
STATE TEXAS
STREET ADDR. 1 4240 SOUTHWEST BOULEVARD
CITY SAN ANGELO
ZIP 76904-5634
OFFICIAL VA NAME SAN ANGELO CBOC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME SAN ANGELO VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1346288891
TAXONOMY CODE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 519HF
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1346288891
  • CODING SYSTEM:   VASTANUM
    ID:   519HF
  • CODING SYSTEM:   CLIA
    ID:   45D1042349