Provider Demographics
NPI:1083851281
Name:CICLINTON RHEUMATOLOGY PLLC
Entity Type:Organization
Organization Name:CICLINTON RHEUMATOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:I
Authorized Official - Last Name:CLINTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-591-0688
Mailing Address - Street 1:11844 BANDERA RD # 706
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4132
Mailing Address - Country:US
Mailing Address - Phone:210-591-0688
Mailing Address - Fax:210-858-0088
Practice Address - Street 1:18585 SIGMA RD STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4204
Practice Address - Country:US
Practice Address - Phone:210-591-0688
Practice Address - Fax:210-858-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-10
Last Update Date:2010-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8609207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty