Provider Demographics
NPI:1699852665
Name:CORTADA, XAVIER RAMON (MD)
Entity Type:Individual
Prefix:DR
First Name:XAVIER
Middle Name:RAMON
Last Name:CORTADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13750 SAN PEDRO AVE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4375
Mailing Address - Country:US
Mailing Address - Phone:210-490-3434
Mailing Address - Fax:210-489-4977
Practice Address - Street 1:13750 SAN PEDRO AVE
Practice Address - Street 2:SUITE 850
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4375
Practice Address - Country:US
Practice Address - Phone:210-490-3434
Practice Address - Fax:210-489-4977
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH3666208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD54060Medicare UPIN