Provider Demographics
NPI:1457674889
Name:EMAN MINA, M.D., P.A.
Entity Type:Organization
Organization Name:EMAN MINA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-497-7700
Mailing Address - Street 1:PO BOX 461467
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78246-1467
Mailing Address - Country:US
Mailing Address - Phone:210-699-6377
Mailing Address - Fax:210-699-1127
Practice Address - Street 1:18626 HARDY OAK BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4210
Practice Address - Country:US
Practice Address - Phone:210-497-7700
Practice Address - Fax:210-402-6815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0981207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB101348Medicare PIN