Provider Demographics
NPI:1518029842
Name:HUNT, CONSUELA U (MD)
Entity Type:Individual
Prefix:
First Name:CONSUELA
Middle Name:U
Last Name:HUNT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 E HOUSTON ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2990
Mailing Address - Country:US
Mailing Address - Phone:866-219-8595
Mailing Address - Fax:
Practice Address - Street 1:110 E HOUSTON ST STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2990
Practice Address - Country:US
Practice Address - Phone:866-219-8595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034360208000000X
IN01067087A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200955350Medicaid
IN200955350Medicaid