Individual
CARIDAD M. REBOLLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2902 GOLIAD RD, SUITE 103, SAN ANTONIO, TX 78223-3958
(210) 337-4911
(210) 337-7749
Mailing address
7142 SAN PEDRO AVE, SUITE 120, SAN ANTONIO, TX 78216-6254
(210) 661-5622
(210) 395-4012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
K3419
TX
207RN0300X
Nephrology Physician
Primary
K3419
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110207848
MEDICARE RAILROAD
TX
05
—
1182636-05
—
TX
05
—
118263603
—
TX
Enumeration date
12/07/2005
Last updated
05/05/2020
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