MEDICARE: RENEE L. CEVEY, M.D., P.A.

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	208000000X	Pediatrics Physician	N0681	TX

General Provider Information

NPI Number	:	1598902207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEE L. CEVEY, M.D., P.A.

Provider Business Mailing Address
First Line	:	414 W SUNSET RD
Second Line	:	SUITE 105
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1756
Country	:	US
Telephone Number	:	210-826-0311
Fax Number	:	210-826-0386

Provider Business Practice Location Address
First Line	:	414 W SUNSET RD
Second Line	:	SUITE 105
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1756
Country	:	US
Telephone Number	:	210-826-0311
Fax Number	:	210-826-0386

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RENEE CEVEY
Credential	:
Telephone Number	:	210-826-0311

Provider Enumeration Date	:	01/16/2009
Last Update Date	:	08/15/2013

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