Individual
DR. JORGE LUIS MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1634 LOCKHILL SELMA RD, SAN ANTONIO, TX 78213-1929
(210) 541-8455
Mailing address
1634 LOCKHILL SELMA RD, SAN ANTONIO, TX 78213-1929
(210) 541-8455
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
K2359
TX
2084P0800X
Psychiatry Physician
Primary
K2359
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149418903
—
TX
Enumeration date
06/13/2006
Last updated
07/11/2024
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