OrganizationBuena Vista Family Practice, P.A.Family MedicineAllopathic & Osteopathic PhysiciansPractice Address1712 Buena Vista St, San Antonio, TX 78207-3803(210) 226-6562PECOS EnrollmentBased on the most recent information from CMS, provider Buena Vista Family Practice, P.A. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1558427989Provider TypeOrganizationFull NameBuena Vista Family Practice, P.A.SubpartNoEnumeration Date12/29/2006Last Updated12/3/2007Contact InformationPractice LocationPractice Address1712 Buena Vista St, San Antonio, TX 78207-3803Phone(210) 226-6562Fax(210) 222-8366Mailing LocationMailing Address1712 Buena Vista St, San Antonio, TX 78207-3803Phone(210) 226-6562Fax(210) 222-8366Authorized OfficialNameSamaniego, Hector Xavier (President)Phone(210) 226-6562Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseH7500Texas