Provider Demographics
NPI:1922171743
Name:DE LLANOS, ARIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIEL
Middle Name:
Last Name:DE LLANOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 BABCOCK RD STE 301
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4428
Mailing Address - Country:US
Mailing Address - Phone:210-858-9980
Mailing Address - Fax:210-858-9990
Practice Address - Street 1:2040 BABCOCK RD STE 301
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4428
Practice Address - Country:US
Practice Address - Phone:210-858-9980
Practice Address - Fax:210-858-9990
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN24652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F21461Medicare PIN