Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 34658 | TX |
Y | 103TC0700X | Clinical Psychologist | 34658 | TX |
NPI | 1003106543 |
---|---|
Provider Name | Dr. Jesus Aranda-Cano |
First Address | San Antonio, TX 78216-4360 |
Second Address | San Antonio, TX 78216-4360 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 30/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
280834701 | (05) | TX |
88225A | BLUE CROSS BLUE SHIELD (01) | TX |