Provider Demographics
NPI:1134180995
Name:TSENG, CLEVERT HUGO (MD)
Entity type:Individual
Prefix:MR
First Name:CLEVERT
Middle Name:HUGO
Last Name:TSENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:219-922-7000
Mailing Address - Fax:210-227-0282
Practice Address - Street 1:315 N SAN SABA STE 1075
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3155
Practice Address - Country:US
Practice Address - Phone:210-922-7000
Practice Address - Fax:210-227-0282
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG1218208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130961907Medicaid
TX130961907Medicaid