1184885295 NPI number — MARIA F FERNANDEZ FALCON MD

Table of content: MARIA F FERNANDEZ FALCON MD (NPI 1184885295)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184885295 NPI number — MARIA F FERNANDEZ FALCON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FERNANDEZ FALCON
Provider First Name:
MARIA
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RICCA
Provider Other First Name:
MARIA
Provider Other Middle Name:
F
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1184885295
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7703 FLOYD CURL DR
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:
78229-3901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-450-9000
Provider Business Mailing Address Fax Number:
210-224-6367

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3939 MEDICAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-2291
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-450-6120
Provider Business Practice Location Address Fax Number:
210-576-1437
Provider Enumeration Date:
06/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  N6295 , 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: 214899104 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com