Provider Demographics
NPI:1487764908
Name:NORTHEAST OB/GYN ASSOCIATES, PLLC
Entity type:Organization
Organization Name:NORTHEAST OB/GYN ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:AKRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-650-9978
Mailing Address - Street 1:1210 ARION PKWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2880
Mailing Address - Country:US
Mailing Address - Phone:210-590-6195
Mailing Address - Fax:210-650-5975
Practice Address - Street 1:8715 VILLAGE DR
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5405
Practice Address - Country:US
Practice Address - Phone:210-590-6195
Practice Address - Fax:210-650-5975
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONSULTANTS IN WOMENS HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-30
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX082726301Medicaid
TX00G82LMedicare ID - Type Unspecified