Provider Demographics
NPI:1013907831
Name:HOSPENTHAL, DUANE RUSSELL (MD, PHD)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:RUSSELL
Last Name:HOSPENTHAL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8042 WURZBACH RD STE 280
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3863
Mailing Address - Country:US
Mailing Address - Phone:210-614-8100
Mailing Address - Fax:210-615-7233
Practice Address - Street 1:8715 VILLAGE DR STE 514
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5407
Practice Address - Country:US
Practice Address - Phone:210-370-9922
Practice Address - Fax:210-545-5616
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301062322207RI0200X
TXP2264207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease