Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 0102206373 | VA |
NPI | 1043778921 |
---|---|
Provider Name | Matthew A Tunzi |
First Address | San Antonio, TX 78234-4504 |
Second Address | San Antonio, TX 78234-4504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2019 |
Last Update Date | 13/11/2020 |