Provider Demographics
NPI:1518126309
Name:QUINTANILLA, ELEAZAR JR (MD)
Entity Type:Individual
Prefix:
First Name:ELEAZAR
Middle Name:
Last Name:QUINTANILLA
Suffix:JR
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 1:3333 RESEARCH PLZ
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235-5154
Mailing Address - Country:US
Mailing Address - Phone:210-297-6500
Mailing Address - Fax:210-297-0352
Practice Address - Street 1:3333 RESEARCH PLZ
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-5154
Practice Address - Country:US
Practice Address - Phone:210-297-6500
Practice Address - Fax:210-297-0352
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1085207R00000X, 208M00000X
HIE14821208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine