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Organization
RONALD J. REARDON, M.D., P.A.
Active
Organization
RONALD J. REARDON, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD J. REARDON M.D. (PRESIDENT)
(210) 403-3490
Entity
Organization
Contact information
Practice address
540 MADISON OAK DR, SUITE 340, SAN ANTONIO, TX 78258-3921
(210) 403-3490
(210) 403-2042
Mailing address
PO BOX 690868, SAN ANTONIO, TX 78269-0868
(210) 403-3490
(210) 403-2042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G5519
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00769L
MEDICARE PTAN
TX
01
—
0107PU
BCBS
TX
01
—
DR5045
RAILROAD MEDICARE PROVIDER NUMBER
TX
Enumeration date
02/26/2007
Last updated
02/09/2012
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