Provider Demographics
NPI:1134160377
Name:CLEVELAND-TRAYLOR, AMELIA (MD)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:CLEVELAND-TRAYLOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:
Other - Last Name:CLEVELAND-TRAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8210 CALLAGHAN RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4775
Mailing Address - Country:US
Mailing Address - Phone:210-233-7000
Mailing Address - Fax:
Practice Address - Street 1:8210 CALLAGHAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4775
Practice Address - Country:US
Practice Address - Phone:210-233-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2025-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-6154-C207V00000X
NY251359207V00000X
TXR8547207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03082120Medicaid
OH0979320Medicaid
OHF87576Medicare UPIN
OH0979320Medicaid
NYJ400002641Medicare PIN