1689631053 NPI number — ZENAIDA ECLARINAL M.D.

Table of content: ZENAIDA ECLARINAL M.D. (NPI 1689631053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689631053 NPI number — ZENAIDA ECLARINAL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ECLARINAL
Provider First Name:
ZENAIDA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1689631053
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6800 PARK TEN BLVD STE 200S
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:
78213-4293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-261-1000
Provider Business Mailing Address Fax Number:
210-261-1821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
928 W COMMERCE ST
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:
78207-4444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-261-1200
Provider Business Practice Location Address Fax Number:
210-434-0716
Provider Enumeration Date:
04/28/2006

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: 2084P0800X , with the licence number:  E4315 , 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: 140844506 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 140844501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8CU835 . This is a "BCBS TX" identifier . This identifiers is of the category "OTHER".
  • Identifier: 140844502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8DJ846 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 140844504 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00460104 . This is a "MEDICARE RR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8U9622 . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: P00951159 . This is a "RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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