Provider Demographics
NPI:1083645964
Name:MENA, ROLAND F (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROLAND
Middle Name:F
Last Name:MENA
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:426 CASTROVILLE RD, STE #4
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207
Mailing Address - Country:US
Mailing Address - Phone:210-994-6181
Mailing Address - Fax:210-973-5819
Practice Address - Street 1:1805 CASTROVILLE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-3659
Practice Address - Country:US
Practice Address - Phone:210-433-6909
Practice Address - Fax:210-433-6907
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2015-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA00125363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant