Provider Demographics
NPI:1528034758
Name:MUELLER, CHERYL HACKER (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:HACKER
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9480 HUEBNER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1657
Mailing Address - Country:US
Mailing Address - Phone:210-614-8090
Mailing Address - Fax:210-614-7733
Practice Address - Street 1:9480 HUEBNER RD
Practice Address - Street 2:#100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1657
Practice Address - Country:US
Practice Address - Phone:210-614-8090
Practice Address - Fax:210-614-7733
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP0000JZO11Medicaid
8D2732Medicare ID - Type Unspecified
TXP0000JZO11Medicaid