Provider Demographics
NPI:1366251472
Name:SCARLETT PHOENIX INC.
Entity type:Organization
Organization Name:SCARLETT PHOENIX INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUNNELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-718-4046
Mailing Address - Street 1:914 E ELMIRA ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-1716
Mailing Address - Country:US
Mailing Address - Phone:210-483-6255
Mailing Address - Fax:
Practice Address - Street 1:914 E ELMIRA ST STE 203
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-1716
Practice Address - Country:US
Practice Address - Phone:210-483-6255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Single Specialty