Provider Demographics
NPI:1346310968
Name:ONTIVEROS, MARGARITA M (MD)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:M
Last Name:ONTIVEROS
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 1:311 CAMDEN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-2012
Mailing Address - Country:US
Mailing Address - Phone:210-281-9800
Mailing Address - Fax:210-281-1001
Practice Address - Street 1:311 CAMDEN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-2012
Practice Address - Country:US
Practice Address - Phone:210-281-9800
Practice Address - Fax:210-281-1001
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH5196207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0083HBOtherBLUE CROSS BLUE SHIELD
TX123672105Medicaid
TX123672105Medicaid
TXF91451Medicare UPIN