Individual
MICHAEL CORNEILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11212 STATE HIGHWAY 151 STE 230, SAN ANTONIO, TX 78251-4501
(830) 643-7000
Mailing address
7390 BARLITE BLVD, # 230, SAN ANTONIO, TX 78224-1337
(602) 633-3721
(602) 995-3795
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
46604
AZ
2086S0102X
Surgical Critical Care Physician
Primary
L6843
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163414909
—
TX
01
—
P02601720
MCRR
TX
Enumeration date
08/24/2006
Last updated
04/09/2021
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