Organization
ANGEL R JIMENEZ MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGEL R JIMENEZ MD (PRESIDENT)
(210) 224-5563
Entity
Organization
Contact information
Practice address
16099 NW MILITARY HWY, SHAVANO PARK, TX 78231-1217
(210) 224-5563
Mailing address
16099 NW MILITARY HWY, SHAVANO PARK, TX 78231-1217
(210) 224-5563
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
D4170
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035278302
INDIV TPI
TX
01
—
1043466857
GROUP NPI
TX
01
—
1174526628
INDIVIDUAL NPI
TX
05
—
199960901
—
TX
Enumeration date
08/12/2008
Last updated
02/07/2010
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