| Clinica Monterrey Pa | |
|
5138 Ashton Audrey San Antonio TX 78249-1792 | |
| (210) 334-3330 | |
| (210) 334-3334 |
| Full Name | Clinica Monterrey Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 5138 Ashton Audrey, San Antonio, Texas |
| Authorized Official Name and Position | Victor Manuel Martinez-soria (PRESIDENT) |
| Authorized Official Contact | 2108271014 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica Monterrey Pa 5138 Ashton Audrey San Antonio TX 78249-1792 Ph: (210) 334-3330 | Clinica Monterrey Pa 5138 Ashton Audrey San Antonio TX 78249-1792 Ph: (210) 334-3330 |
| NPI Number | 1780865709 |
|---|---|
| Provider Enumeration Date | 11/19/2007 |
| Last Update Date | 07/27/2010 |
| Medicare PECOS PAC ID | 5092870238 |
|---|---|
| Medicare Enrollment ID | O20090223000160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780865709 | NPI | - | NPPES |
| 158467401 | Medicaid | TX | |
| 158468201 | Medicaid | TX | |
| 8J9020 | Other | TX | BCBS |
| 0016KK | Other | TX | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | K4498 (Texas) | Primary |
| Provider Name | Victor Manuel Martinez-soria |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356471353 PECOS PAC ID: 8628133865 Enrollment ID: I20101111001329 |
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