Provider Demographics
NPI:1770565707
Name:CHING, ROBERT T (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:CHING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1150 N LOOP 1604 W
Mailing Address - Street 2:#108-628
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-4503
Mailing Address - Country:US
Mailing Address - Phone:210-337-2600
Mailing Address - Fax:210-337-2644
Practice Address - Street 1:7115 FAIRLAWN DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-4022
Practice Address - Country:US
Practice Address - Phone:210-337-2600
Practice Address - Fax:210-337-2644
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ9642207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121238301Medicaid
G18496Medicare UPIN
TX00T93VMedicare PIN