Individual
DR. DANIEL GENE CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8401 DATAPOINT DR, SUITE 600, SAN ANTONIO, TX 78229-5900
(210) 616-7796
(210) 616-7799
Mailing address
8401 DATAPOINT DR STE 600, P. O. BOX 29441, SAN ANTONIO, TX 78229-5907
(210) 616-7796
(210) 616-7799
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
M0042
TX
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
M0042
TX
2085N0700X
Neuroradiology Physician
M0042
TX
2085N0904X
Nuclear Radiology Physician
M0042
TX
2085P0229X
Pediatric Radiology Physician
M0042
TX
2085R0202X
Diagnostic Radiology Physician
Primary
M0042
TX
2085R0204X
Vascular & Interventional Radiology Physician
M0042
TX
2085U0001X
Diagnostic Ultrasound Physician
M0042
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2027005-01
—
TX
01
—
2027005-02
MEDICAID - CSHCN
TX
01
—
2027005-03
MEDICAID - STRIC
TX
01
—
8L14244
MEDICARE - STRIC
TX
01
—
M0042
TEXAS MEDICAL BOARD
TX
01
—
P00736456
RAILROAD MEDICARE
TX
01
—
P00855904
RAILROAD MEDICARE
TX
Enumeration date
06/20/2007
Last updated
03/24/2016
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