Individual
DR. CARLOS ROBERTO JAEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4647 MEDICAL DR, SAN ANTONIO, TX 78229-4403
(210) 592-0400
Mailing address
6605 COUNTESS ADRIA ST, SAN ANTONIO, TX 78238-1510
(210) 567-4553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L4467
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145256701
—
TX
Enumeration date
11/02/2005
Last updated
07/08/2007
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