Organization
MARIO A. QUINTANILLA MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO A. QUINTANILLA MD (MD)
(361) 993-4793
Entity
Organization
Contact information
Practice address
5866 S STAPLES ST, SUITE #401, CORPUS CHRISTI, TX 78413-3700
(361) 993-4793
(361) 993-1118
Mailing address
5866 S STAPLES ST, SUITE #401, CORPUS CHRISTI, TX 78413-3700
(361) 993-4793
(361) 993-1118
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
F1201
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139788713
—
TX
Enumeration date
08/20/2011
Last updated
08/20/2011
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