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Organization
TRI DANG D O PA
Active
Organization
TRI DANG D O PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA ERNESTINA GALLEGOS (OFFICE MANAGER)
(210) 977-9080
Entity
Organization
Contact information
Practice address
7430 BARLITE BLVD STE 103, SAN ANTONIO, TX 78224-1366
(210) 977-9080
(210) 977-8480
Mailing address
7430 BARLITE BLVD STE 103, SAN ANTONIO, TX 78224-1366
(210) 977-9080
(210) 977-8480
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L1015
TX
208000000X
Pediatrics Physician
L1015
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L1015
MEDICAL LICENSE
TX
Enumeration date
08/16/2007
Last updated
08/17/2007
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