Guillermo I Rocha, Md, Pa | |
3727 Roosevelt Ave San Antonio TX 78214-2934 | |
(210) 922-5922 | |
(210) 924-5600 |
Full Name | Guillermo I Rocha, Md, Pa |
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Speciality | Clinic/Center |
Location | 3727 Roosevelt Ave, San Antonio, Texas |
Authorized Official Name and Position | Guillermo Ismael Rocha (OWNER) |
Authorized Official Contact | 2109225922 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Guillermo I Rocha, Md, Pa 3727 Roosevelt Ave San Antonio TX 78214-2934 Ph: (210) 922-5922 | Guillermo I Rocha, Md, Pa 3727 Roosevelt Ave San Antonio TX 78214-2934 Ph: (210) 922-5922 |
NPI Number | 1508900622 |
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Provider Enumeration Date | 02/20/2007 |
Last Update Date | 10/01/2020 |
Medicare PECOS PAC ID | 0749291714 |
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Medicare Enrollment ID | O20090415000123 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508900622 | NPI | - | NPPES |
120476004 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | G6382 (Texas) | Primary |
261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
Provider Name | Guillermo I Rocha |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1548269335 PECOS PAC ID: 0042315814 Enrollment ID: I20070502000414 |
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