Provider Demographics
NPI:1205943370
Name:BINGAMAN, ADAM W (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:W
Last Name:BINGAMAN
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 1:8109 FREDERICKSBURG RD
Mailing Address - Street 2:PHYSICIAN PRACTICE SERVICES
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3311
Mailing Address - Country:US
Mailing Address - Phone:210-575-8514
Mailing Address - Fax:210-575-8004
Practice Address - Street 1:8201 EWING HALSELL DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3707
Practice Address - Country:US
Practice Address - Phone:210-575-8514
Practice Address - Fax:210-575-8004
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5697204F00000X
TXM5637208600000X
GA46738204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W0136OtherBCBS
TX183293305OtherCSN
P00996226OtherMEDICARE RAILROAD
TX183293304Medicaid
P00996226OtherMEDICARE RAILROAD