Provider Demographics
NPI:1801894944
Name:GERALDE, RENATO A (DO)
Entity type:Individual
Prefix:DR
First Name:RENATO
Middle Name:A
Last Name:GERALDE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:150 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4098
Mailing Address - Country:US
Mailing Address - Phone:210-481-6800
Mailing Address - Fax:210-481-1444
Practice Address - Street 1:150 E SONTERRA BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4098
Practice Address - Country:US
Practice Address - Phone:210-481-6800
Practice Address - Fax:210-481-1444
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2014-02-28
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Provider Licenses
StateLicense IDTaxonomies
TXM0728207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH62322Medicare UPIN
TXH62322Medicare UPIN