MEDICARE: DEEPA PADIA DO

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
1	207Q00000X	Family Medicine Physician	M5868	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	M5868	OTHER	TX	TX LICENSE NUMBER
3	8AE503	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1174729560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEEPA PADIA DO

Provider Business Mailing Address
First Line	:	1045 CENTRAL PARKWAY NORTH
Second Line	:	SUITE 200
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-5024
Country	:	US
Telephone Number	:	210-541-4500
Fax Number	:	210-541-4508

Provider Business Practice Location Address
First Line	:	5000 BAPTIST HEALTH DR
Second Line	:	STE 102
City	:	SCHERTZ
State	:	TX
Zip	:	78154-1193
Country	:	US
Telephone Number	:	210-566-2656
Fax Number	:	210-566-2690

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2007
Last Update Date	:	06/21/2011

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Directions to “ DEEPA PADIA DO” Practice Location

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