Provider Demographics
NPI:1922052570
Name:FEUILLET, PABLO M (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:M
Last Name:FEUILLET
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13423 BLANCO RD
Mailing Address - Street 2:PMB #210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2187
Mailing Address - Country:US
Mailing Address - Phone:210-491-7700
Mailing Address - Fax:210-247-9630
Practice Address - Street 1:1922 DRY CREEK WAY
Practice Address - Street 2:SUITE 134
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
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2018-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK5101207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113519605Medicaid
TX00069XOtherMEDICARE GROUP
TX00069XOtherMEDICARE GROUP
TX8C0893Medicare PIN