Individual
DR. MICHAEL DEGAETANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5620 LONE STAR PKWY # 2, SAN ANTONIO, TX 78253-2202
(210) 403-7978
(210) 680-0206
Mailing address
16620 N US HIGHWAY 281 STE 300, SAN ANTONIO, TX 78232-2679
(210) 614-1231
(210) 499-0811
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
M1624
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176166001
—
TX
Enumeration date
02/24/2006
Last updated
10/26/2022
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