Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | K3419 | TX |
N | 111NI0900X | Internist | K3419 | TX |
Y | 207RN0300X | Nephrologist | K3419 | TX |
NPI | 1073598520 |
---|---|
Provider Name | Caridad M. Rebollar |
First Address | San Antonio, TX 78216-6254 |
Second Address | San Antonio, TX 78223-3958 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 05/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110207848 | MEDICARE RAILROAD (01) | TX |
118263603 | (05) | TX |
1182636-05 | (05) | TX |
G48390 | (02) | TX |