Provider Demographics
NPI:1407149149
Name:ALBERT, LADISLAU JR (MD)
Entity Type:Individual
Prefix:
First Name:LADISLAU
Middle Name:
Last Name:ALBERT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 205124
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-5724
Mailing Address - Country:US
Mailing Address - Phone:210-255-9835
Mailing Address - Fax:210-255-8026
Practice Address - Street 1:4611 CENTERVIEW
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1202
Practice Address - Country:US
Practice Address - Phone:210-255-8935
Practice Address - Fax:210-255-8026
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN8266207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208351101Medicaid
TX285896101Medicaid
TX285896101Medicaid
TX0A4954Medicare PIN