| Cristo Rey Clinic, Pa | |
|
1207 Brooklyn Ave San Antonio TX 78212-4804 | |
| (210) 229-9100 | |
| Not Available |
| Full Name | Cristo Rey Clinic, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1207 Brooklyn Ave, San Antonio, Texas |
| Authorized Official Name and Position | Joel Pena (PRESIDENT) |
| Authorized Official Contact | 2102299100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cristo Rey Clinic, Pa 1207 Brooklyn Ave San Antonio TX 78212-4804 Ph: (210) 229-9100 | Cristo Rey Clinic, Pa 1207 Brooklyn Ave San Antonio TX 78212-4804 Ph: (210) 229-9100 |
| NPI Number | 1316067903 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7810071453 |
|---|---|
| Medicare Enrollment ID | O20080221000171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316067903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Joel Pena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588653455 PECOS PAC ID: 4880776335 Enrollment ID: I20080123000641 |
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