Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | J6898 | TX |
NPI | 1023095965 |
---|---|
Provider Name | Paul V Celio |
First Address | San Antonio, TX 78229-3824 |
Second Address | San Antonio, TX 78229-3824 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2005 |
Last Update Date | 08/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
118360005 | (05) | TX |
8CM500 | BCBS (01) | TX |
C40410 | (02) | TX |
P00914967 | RAILROAD MEDICARE (01) | TX |
TXB117844 | MEDICARE (01) | TX |