Individual
DR. EDGAR SAMUEL MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 E SONTERRA BLVD STE 375, SAN ANTONIO, TX 78258-4321
(210) 908-6337
(855) 999-3755
Mailing address
19141 STONE OAK PKWY SUITE 104, PMB 217, SAN ANTONIO, TX 78258-3367
(210) 908-6337
(855) 999-3755
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
A117829
CA
2084P0800X
Psychiatry Physician
Primary
Q4634
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3577181-01
—
TX
Enumeration date
08/17/2011
Last updated
01/31/2024
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