Provider Demographics
NPI:1023115292
Name:VIRLAR-CADENA, JESUS ALFREDO (MD)
Entity type:Individual
Prefix:
First Name:JESUS
Middle Name:ALFREDO
Last Name:VIRLAR-CADENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JESUS
Other - Middle Name:ALFREDO
Other - Last Name:VIRLAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:17827 SALADO DRAW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-1602
Mailing Address - Country:US
Mailing Address - Phone:210-625-8698
Mailing Address - Fax:210-503-7157
Practice Address - Street 1:1302 S GENERAL MCMULLEN DR
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78237-4200
Practice Address - Country:US
Practice Address - Phone:210-904-8770
Practice Address - Fax:210-370-3745
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7592207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1629461-01Medicaid
TXH98876Medicare UPIN
TX1629461-01Medicaid
TX489939ZURRMedicare PIN