Individual
MARIO A QUINTANILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5151 FLYNN PKWY STE 307, CORPUS CHRISTI, TX 78411-4384
(361) 993-4835
(361) 993-7043
Mailing address
5151 FLYNN PKWY STE 307, CORPUS CHRISTI, TX 78411-4384
(361) 993-4835
(361) 993-7043
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
F1201
TX
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
F1201
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139788728
—
TX
01
—
8FT501
BC/BS TX
—
Enumeration date
03/20/2006
Last updated
11/22/2024
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