| Leticia A Poret Md Pa | |
|
4522 Fredericksburg Rd Suite A 14 San Antonio TX 78201-6521 | |
| (210) 733-3005 | |
| Not Available |
| Full Name | Leticia A Poret Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 4522 Fredericksburg Rd, San Antonio, Texas |
| Authorized Official Name and Position | Leticia Ann Poret (PHYSICIAN) |
| Authorized Official Contact | 2107333005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leticia A Poret Md Pa 12627 Stonehenge Dr San Antonio TX 78230-1941 Ph: (210) 733-3005 | Leticia A Poret Md Pa 4522 Fredericksburg Rd Suite A 14 San Antonio TX 78201-6521 Ph: (210) 733-3005 |
| NPI Number | 1114024478 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 01/15/2008 |
| Medicare PECOS PAC ID | 9830282714 |
|---|---|
| Medicare Enrollment ID | O20070908000149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114024478 | NPI | - | NPPES |
| 0009QF | Other | TX | BC BS |
| 00182U | Other | TX | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | H9289 (Texas) | Primary |
| Provider Name | Leticia A Poret |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578763462 PECOS PAC ID: 2567555444 Enrollment ID: I20080201000291 |
| Provider Name | Hetta H Atkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881945830 PECOS PAC ID: 2961635743 Enrollment ID: I20140501000754 |
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