Provider Demographics
NPI:1558367706
Name:PULMONARY CONSULTANTS OF SAN ANTONIO, PA
Entity Type:Organization
Organization Name:PULMONARY CONSULTANTS OF SAN ANTONIO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ALONZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-692-0361
Mailing Address - Street 1:10007 HUEBNER RD STE 402
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1640
Mailing Address - Country:US
Mailing Address - Phone:210-692-0361
Mailing Address - Fax:210-692-0151
Practice Address - Street 1:10007 HUEBNER RD STE 402
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1640
Practice Address - Country:US
Practice Address - Phone:210-692-0361
Practice Address - Fax:210-692-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141588701Medicaid
TXH72914Medicare UPIN
TXC23767Medicare UPIN
TX141588701Medicaid
TXB87581Medicare UPIN
TXE46800Medicare UPIN