Individual
DR. PHILIP O PONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
903 W MARTIN ST, SAN ANTONIO, TX 78207
(210) 358-3710
(210) 358-5941
Mailing address
903 W MARTIN ST, SAN ANTONIO, TX 78207-0903
(210) 358-3710
(210) 358-5941
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A104091
CA
207R00000X
Internal Medicine Physician
R9122
TX
207RI0200X
Infectious Disease Physician
Primary
R9122
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390363501
—
TX
01
—
390363502
CSHCN
TX
Enumeration date
08/15/2008
Last updated
12/13/2018
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