Provider Demographics
NPI:1306021266
Name:SATTERFIELD, TIFFANY M
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:M
Last Name:SATTERFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:M
Other - Last Name:SATTERFIELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 1506
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78295-1506
Mailing Address - Country:US
Mailing Address - Phone:210-692-9500
Mailing Address - Fax:210-678-3482
Practice Address - Street 1:7711 LOUIS PASTEUR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3422
Practice Address - Country:US
Practice Address - Phone:210-692-9500
Practice Address - Fax:210-678-3482
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3291207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210559501Medicaid
TX8L23876Medicare UPIN
TX8CB747Medicare PIN