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NPI Code Detail

MEDICARE: ILIANA AMAYA GREVER M.D.

MEDICARE:   ILIANA  AMAYA GREVER  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) PhysicianL7301TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063445260
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILIANA AMAYA GREVER M.D.
Provider Business Mailing Address
First Line : 711 W BAY AREA BLVD
Second Line : SUITE #500
City : WEBSTER
State : TX
Zip : 77598-4043
Country : US
Telephone Number : 281-554-2200
Fax Number : 281-554-5189
Provider Business Practice Location Address
First Line : 16620 N US HIGHWAY 281 STE 300
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-2679
Country : US
Telephone Number : 210-309-1405
Fax Number : 210-688-4596
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 05/16/2019

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Directions to “ ILIANA AMAYA GREVER M.D.” Practice Location

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