Individual
DR. JERRY J TOMASOVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 OAK CENTRE DR, SUITE #400, SAN ANTONIO, TX 78258-3944
(210) 615-2333
(210) 490-5024
Mailing address
PO BOX 34713, SAN ANTONIO, TX 78265-4713
(210) 615-2333
(210) 490-5024
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
G7730
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00891N
BLUE CROSS ID #
TX
05
—
095077602
—
TX
05
—
132968207
—
TX
05
—
132968209
—
TX
01
—
742506891
TAX ID
TX
01
—
8AP903
BCBSTX THRU HILL COUNTRY
TX
01
—
P00728995
RAILROAD MEDICARE THRU HILL COUNTRY MONITORING
TX
Enumeration date
06/04/2006
Last updated
10/20/2009
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