Provider Demographics
NPI:1831236371
Name:DENOIA, EMANUEL PHILIP (MD)
Entity type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:PHILIP
Last Name:DENOIA
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:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3311
Mailing Address - Country:US
Mailing Address - Phone:210-614-0062
Mailing Address - Fax:210-616-0408
Practice Address - Street 1:8109 FREDERICKSBURG RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3311
Practice Address - Country:US
Practice Address - Phone:210-614-0062
Practice Address - Fax:210-616-0408
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF51831744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC15188Medicare UPIN