VICKI J SPARKS, MD, PC
Ambulatory Health at Southbridge St, San Antonio, TX

License number
Texas E6215
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. VICKI JEAN SPARKS MD
Title: OWNER
Phone: (210) 340-2707
Address
Address
114 Southbridge St SUITE D, San Antonio, TX 78216
National Provider ID: 1033545363
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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VICKI J. SPARKS, M.D., PC

1543 W Smt Ave, San Antonio, TX 78201

Industry:
Medical Doctor's Office
Doing business as:
Vicki J. Sparks, M.D., PC
Registration:
Feb 26, 2008
State ID:
0800943821
Business type:
Domestic Professional Corporation
PRESIDENT, Director , President:
Vicki J Sparks (PRESIDENT, Director , President), 114 Southbridge St SUITE D, San Antonio, TX 78212
Agent:
Law Offices Of Rogelio Lopez, Pc,1543 W Smt, San Antonio, TX 78201 (Physical)
TIN:
32034797392

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