Provider Demographics
NPI:1356572887
Name:LLANOS-VASQUEZ, ROXANNA M (MD)
Entity type:Individual
Prefix:
First Name:ROXANNA
Middle Name:M
Last Name:LLANOS-VASQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROXANNA
Other - Middle Name:M
Other - Last Name:LLANOS VASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9727 POTEET JOURDANTON FWY
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78211-4574
Mailing Address - Country:US
Mailing Address - Phone:210-923-4372
Mailing Address - Fax:210-923-5581
Practice Address - Street 1:9727 POTEET JOURDANTON FWY
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-4574
Practice Address - Country:US
Practice Address - Phone:210-923-4372
Practice Address - Fax:210-923-5581
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9900207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine