Individual
MRS. MIRIAM CANTU BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1434 E SONTERRA BLVD STE 105, SAN ANTONIO, TX 78258-4972
(210) 479-3000
(210) 479-3016
Mailing address
333 N SANTA ROSA ST, SUITE D4023, SAN ANTONIO, TX 78207-3108
(469) 282-2711
(469) 282-2609
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K2410
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111761604
—
TX
05
—
111761605
—
TX
01
—
1265475891
GROUP NPI
TX
05
—
173321401
—
TX
Enumeration date
06/14/2006
Last updated
03/18/2019
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