Provider Demographics
NPI:1366440547
Name:MERIN, ALAN JACOB (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:JACOB
Last Name:MERIN
Suffix:
Gender:M
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:PO BOX 291169
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-1769
Mailing Address - Country:US
Mailing Address - Phone:210-224-1079
Mailing Address - Fax:210-281-0248
Practice Address - Street 1:1211 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-3307
Practice Address - Country:US
Practice Address - Phone:210-224-1079
Practice Address - Fax:210-281-0248
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6041207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C03517Medicare UPIN
TX83J096Medicare ID - Type Unspecified