Individual
MICHELLE TAVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
(210) 358-0647
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-4000
(210) 358-0647
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
U6355
TX
208M00000X
Hospitalist Physician
Primary
U6355
TX
Other
Enumeration date
04/23/2020
Last updated
09/25/2023
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