| Ronald J. Reardon, M.d., P.a. | |
|
540 Madison Oak Dr Suite 340 San Antonio TX 78258-3921 | |
| (210) 403-3490 | |
| (210) 403-2042 |
| Full Name | Ronald J. Reardon, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 540 Madison Oak Dr, San Antonio, Texas |
| Authorized Official Name and Position | Ronald J. Reardon (PRESIDENT) |
| Authorized Official Contact | 2104033490 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald J. Reardon, M.d., P.a. Po Box 690868 San Antonio TX 78269-0868 Ph: (210) 403-3490 | Ronald J. Reardon, M.d., P.a. 540 Madison Oak Dr Suite 340 San Antonio TX 78258-3921 Ph: (210) 403-3490 |
| NPI Number | 1629104146 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 02/09/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629104146 | NPI | - | NPPES |
| 0107PU | Other | TX | BCBS |
| 00769L | Other | TX | MEDICARE PTAN |
| DR5045 | Other | TX | RAILROAD MEDICARE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G5519 (Texas) | Primary |
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