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Organization
NORTHEAST INTERNAL MEDICAL ASSOCIATES PLLC
Active
Organization
NORTHEAST INTERNAL MEDICAL ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBERTA S. CLOUD (VICE PRESIDENT)
(210) 575-8505
Entity
Organization
Contact information
Practice address
12602 TOEPPERWEIN RD, SUITE #100, SAN ANTONIO, TX 78233-3269
(210) 650-9669
(210) 650-0750
Mailing address
12602 TOEPPERWEIN RD, SUITE #100, SAN ANTONIO, TX 78233-3269
(210) 650-9669
(210) 650-0750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0075RH
BCBS
TX
05
—
1980823-01
—
TX
01
—
DN3280
RAILROAD
—
Enumeration date
03/25/2008
Last updated
10/28/2010
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