Organization
MALDONADO PSYCHIATRIC ASSOCIATION
Active
Other names
Jorge Maldonado
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMMY FOUNTAIN (OFFICE MANAGER)
(210) 541-8455
Entity
Organization
Contact information
Practice address
1634 LOCKHILL SELMA RD, SAN ANTONIO, TX 78213-1929
(210) 541-8455
Mailing address
1634 LOCKHILL SELMA RD, SAN ANTONIO, TX 78213-1929
(210) 541-8455
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
K2359
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149418903
—
TX
Enumeration date
11/14/2008
Last updated
09/21/2010
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