Individual
DR. CHARLES G. BRISENO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
SUITE 703 414 NAVARRO, SAN ANTONIO, TX 78205-2515
(210) 224-4811
(210) 224-8678
Mailing address
SUITE 703 414 NAVARRO, SAN ANTONIO, TX 78205-2515
(210) 224-4811
(210) 224-8678
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D3167
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
834022
BCBS
—
Enumeration date
01/26/2006
Last updated
12/11/2007
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