Provider Demographics
NPI:1235313016
Name:MINA, EMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EMAN
Middle Name:
Last Name:MINA
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 1:18626 HARDY OAK BLVD STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4219
Mailing Address - Country:US
Mailing Address - Phone:210-497-7700
Mailing Address - Fax:210-402-6815
Practice Address - Street 1:18626 HARDY OAK BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4210
Practice Address - Country:US
Practice Address - Phone:210-497-7700
Practice Address - Fax:210-402-6815
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0981207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB101349Medicare PIN
613606Medicare PIN