Provider Demographics
NPI:1467575548
Name:G. SCOTT CUMING IV, M.D.
Entity Type:Organization
Organization Name:G. SCOTT CUMING IV, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:G.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:CUMING
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:210-696-2800
Mailing Address - Street 1:8647 WURZBACH RD BLDG O
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1245
Mailing Address - Country:US
Mailing Address - Phone:210-696-2800
Mailing Address - Fax:210-696-6245
Practice Address - Street 1:8647 WURZBACH RD BLDG O
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1245
Practice Address - Country:US
Practice Address - Phone:210-696-2800
Practice Address - Fax:210-696-6245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE42812080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE88613Medicare UPIN