| Cielo Vista Medical Practice P.a. | |
|
21604 Cielo Ridge Dr San Antonio TX 78256-9604 | |
| (210) 683-1329 | |
| (210) 615-1636 |
| Full Name | Cielo Vista Medical Practice P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 21604 Cielo Ridge Dr, San Antonio, Texas |
| Authorized Official Name and Position | Serina Marie Flores (OWNER/PRESIDENT) |
| Authorized Official Contact | 2106831329 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cielo Vista Medical Practice P.a. Po Box 29408 San Antonio TX 78229-0408 Ph: (210) 615-1626 | Cielo Vista Medical Practice P.a. 21604 Cielo Ridge Dr San Antonio TX 78256-9604 Ph: (210) 683-1329 |
| NPI Number | 1154772531 |
|---|---|
| Provider Enumeration Date | 06/27/2016 |
| Last Update Date | 03/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154772531 | NPI | - | NPPES |
| L8057 | Other | TX | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | L8057 (Texas) | Primary |
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