Organization
RADIOLOGY ASSOCIATION P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAUL ALEJANDRO PELAEZ ANTELO M.D. (OWNER)
(830) 257-8484
Entity
Organization
Contact information
Practice address
2 DAVENTRY LN, SAN ANTONIO, TX 78257-1239
(830) 257-8484
(830) 896-5211
Mailing address
PO BOX 291286, KERRVILLE, TX 78029-1286
(830) 257-8484
(830) 896-5211
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
H1175
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0644U
BLUE CROSS
TX
05
—
177407702
—
TX
Enumeration date
04/25/2007
Last updated
07/14/2008
Update your record
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