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Individual

DAVID L BRISENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 MCCULLOUGH AVE, SUITE 300, SAN ANTONIO, TX 78212-4813
(210) 271-3204
(210) 222-2761
Mailing address
1100 MCCULLOUGH AVE, SUITE 300, SAN ANTONIO, TX 78212-4813
(210) 271-3204
(210) 222-2761

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
H4189
TX
207RC0000X
Cardiovascular Disease Physician
Primary
H4189
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
117548106
TX
01
8CU248
BCBS
TX
01
P00948192
RAILROAD
TX
Enumeration date
07/15/2005
Last updated
01/28/2022
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