Provider Demographics
NPI:1649674953
Name:OSCAR IZNAOLA M.D,, PA
Entity type:Organization
Organization Name:OSCAR IZNAOLA M.D,, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:IZNAOLO-ESQUIVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-239-2851
Mailing Address - Street 1:1141 N LOOP 1604 E # 105-434
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1339
Mailing Address - Country:US
Mailing Address - Phone:361-239-2851
Mailing Address - Fax:361-239-2861
Practice Address - Street 1:100 W HUNTINGTON ST
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-3324
Practice Address - Country:US
Practice Address - Phone:361-239-2851
Practice Address - Fax:361-239-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2126207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty