Provider Demographics
NPI:1447228218
Name:MAYER, PAUL T (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:T
Last Name:MAYER
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 1:2766 HARNEY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234-2688
Mailing Address - Country:US
Mailing Address - Phone:210-291-6818
Mailing Address - Fax:
Practice Address - Street 1:2766 HARNEY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78234-2688
Practice Address - Country:US
Practice Address - Phone:210-291-6818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4329207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184224701Medicaid
TX8W0185OtherBCBS
TXP00650237OtherRAILROAD
TX184224701Medicaid
TX8W0185OtherBCBS
TX8J2892Medicare PIN