Individual
TEODORICO H. JACELDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 SAN PEDRO, SUITE NUMBER 110, SAN ANTONIO, TX 78212-5007
(210) 697-5700
Mailing address
530 SAN PEDRO, SUITE NUMBER 110, SAN ANTONIO, TX 78212-5007
(210) 697-5700
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
E5390
TX
Other
Enumeration date
12/17/2007
Last updated
12/17/2007
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