Provider Demographics
NPI:1497956726
Name:MARIA M. JIRKA, M.D.,P.A.
Entity Type:Organization
Organization Name:MARIA M. JIRKA, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:JIRKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-690-5700
Mailing Address - Street 1:PO BOX 1281
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-1281
Mailing Address - Country:US
Mailing Address - Phone:210-690-5700
Mailing Address - Fax:210-558-5580
Practice Address - Street 1:5979 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-2137
Practice Address - Country:US
Practice Address - Phone:210-690-5700
Practice Address - Fax:210-558-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2114207Q00000X
TXJ4202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX104239203Medicaid
TX00482RMedicare ID - Type Unspecified
TXG97501Medicare UPIN
TX104239203Medicaid