Individual
JAIME ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4410 MEDICAL DR, STE 540, SAN ANTONIO, TX 78229-3755
(210) 575-6240
(210) 575-6280
Mailing address
8109 FREDERICKSBURG RD, PHYSICIAN PRACTICE SERVICES, SAN ANTONIO, TX 78229-3311
(210) 575-6240
(210) 575-6280
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
G2361
TX
208000000X
Pediatrics Physician
G2361
TX
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
G2361
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133046612
—
TX
01
—
133046613
CSHCN
TX
01
—
8BX389
BCBS
TX
Enumeration date
05/28/2006
Last updated
04/04/2012
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