Provider Demographics
NPI:1093946188
Name:FERMIN BRIONES JR MD PA
Entity Type:Organization
Organization Name:FERMIN BRIONES JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:210-872-8060
Mailing Address - Street 1:4242 MEDICAL DRIVE
Mailing Address - Street 2:STE 6300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5640
Mailing Address - Country:US
Mailing Address - Phone:210-614-8400
Mailing Address - Fax:
Practice Address - Street 1:4242 MEDICAL DRIVE
Practice Address - Street 2:STE 6300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5640
Practice Address - Country:US
Practice Address - Phone:210-614-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-06
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN06602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty