Provider Demographics
NPI:1659325215
Name:PABLO MARTIN FEUILLET M D P A
Entity Type:Organization
Organization Name:PABLO MARTIN FEUILLET M D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:FEUILLET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-310-8771
Mailing Address - Street 1:13423 BLANCO ROAD
Mailing Address - Street 2:PMB #210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216
Mailing Address - Country:US
Mailing Address - Phone:210-491-7700
Mailing Address - Fax:210-247-9630
Practice Address - Street 1:1922 DRY CREEK WAY STE 134
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-1839
Practice Address - Country:US
Practice Address - Phone:210-491-7700
Practice Address - Fax:210-247-9630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5101207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0054MDOtherBCBS OF TX
TX167353501Medicaid
TX00069XMedicare PIN
TX167353501Medicaid
TX167353501Medicaid