MEDICARE: CHERYL J KING 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
1	207R00000X	Internal Medicine Physician	K6871	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	110187729	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82213F	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1588693154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHERYL J KING M.D.

Provider Business Mailing Address
First Line	:	4411 E SOUTHCROSS BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-3726
Country	:	US
Telephone Number	:	210-648-9500
Fax Number	:	210-648-9504

Provider Business Practice Location Address
First Line	:	4411 E SOUTHCROSS BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-3726
Country	:	US
Telephone Number	:	210-648-9500
Fax Number	:	210-648-9504

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	03/26/2021

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Directions to “ CHERYL J KING M.D.” Practice Location

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