Provider Demographics
NPI:1205833092
Name:COVIN, CHERE RAE SMITH (MD)
Entity Type:Individual
Prefix:
First Name:CHERE
Middle Name:RAE SMITH
Last Name:COVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHERE
Other - Middle Name:RAE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:215 E QUINCY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-2039
Mailing Address - Country:US
Mailing Address - Phone:210-297-1028
Mailing Address - Fax:210-297-0012
Practice Address - Street 1:2241 NW MILITARY HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-4988
Practice Address - Country:US
Practice Address - Phone:210-541-8689
Practice Address - Fax:210-541-8691
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6134207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E96707Medicare UPIN