Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | P6527 | TX |
NPI | 1043527724 |
---|---|
Provider Name | Fuad Antonio Spath |
First Address | San Antonio, TX 78207-3154 |
Second Address | San Antonio, TX 78207-3154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2010 |
Last Update Date | 02/08/2013 |