Provider Demographics
NPI:1154500239
Name:LUIS BIELER, MD, PA
Entity Type:Organization
Organization Name:LUIS BIELER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BIELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-932-1324
Mailing Address - Street 1:PO BOX 240698
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-0698
Mailing Address - Country:US
Mailing Address - Phone:210-932-1323
Mailing Address - Fax:210-932-1308
Practice Address - Street 1:7127 SOMERSET RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3665
Practice Address - Country:US
Practice Address - Phone:210-932-1323
Practice Address - Fax:210-932-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1366207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AW347OtherBLUE CROSS IND ID
TXDB0671OtherRAILROAD MEDICARE
TX0010RAOtherBLUE CROSS GRP ID
TX118898906Medicaid
TX118898906Medicaid
TX8AW347OtherBLUE CROSS IND ID
TX=========OtherCOMMERICAL