Provider Demographics
NPI:1235293457
Name:QUIROZ, REBECCA A (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:QUIROZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20306 ENCINO LEDGE
Mailing Address - Street 2:STE #103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-1831
Mailing Address - Country:US
Mailing Address - Phone:210-404-0127
Mailing Address - Fax:210-404-0161
Practice Address - Street 1:20306 ENCINO LEDGE
Practice Address - Street 2:STE #103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-1831
Practice Address - Country:US
Practice Address - Phone:210-404-0127
Practice Address - Fax:210-404-0161
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF33331Medicare UPIN
TX00898QMedicare PIN