Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | L3790 | TX |
NPI | 1053306779 |
---|---|
Provider Name | Dr. Armando Edgardo Quinones |
First Address | San Antonio, TX 78232-5024 |
Second Address | San Antonio, TX 78205-2516 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 01/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1961856-01 | (05) | TX |
1961856-02 | (05) | TX |
G23507 | (02) | TX |
P00631382 | RAILROAD MEDICARE (01) | TX |