Provider Demographics
NPI:1932531977
Name:MED CENTER INTENSIVISTS OF SAN ANTONIO
Entity Type:Organization
Organization Name:MED CENTER INTENSIVISTS OF SAN ANTONIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:MELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-690-7400
Mailing Address - Street 1:21 SPURS LN STE 230B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1671
Mailing Address - Country:US
Mailing Address - Phone:210-690-7400
Mailing Address - Fax:210-690-7405
Practice Address - Street 1:21 SPURS LN STE 230B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1671
Practice Address - Country:US
Practice Address - Phone:210-690-7400
Practice Address - Fax:210-690-7405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty