Provider Demographics
NPI:1114936408
Name:ADEN, JOY TARA (MD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:TARA
Last Name:ADEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1355 CENTRAL PKWY S
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5055
Mailing Address - Country:US
Mailing Address - Phone:210-590-6195
Mailing Address - Fax:210-650-5993
Practice Address - Street 1:5000 SCHERTZ PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1399
Practice Address - Country:US
Practice Address - Phone:210-650-9978
Practice Address - Fax:210-650-5975
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL8256207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166119101Medicaid
TX166119102Medicaid
TX8C1144Medicare ID - Type Unspecified
TX8F21876Medicare PIN
TX166119101Medicaid