1154500239 NPI number — LUIS BIELER, MD, PA

Table of content: (NPI 1154500239)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154500239 NPI number — LUIS BIELER, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUIS BIELER, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154500239
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 240698
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78224-0698
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-932-1323
Provider Business Mailing Address Fax Number:
210-932-1308

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7127 SOMERSET RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78211-3665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-932-1323
Provider Business Practice Location Address Fax Number:
210-932-1308
Provider Enumeration Date:
10/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BIELER
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
210-932-1324

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  K1366 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8AW347 . This is a "BLUE CROSS IND ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: DB0671 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0010RA . This is a "BLUE CROSS GRP ID" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 118898906 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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