MEDICARE: DR. JUAN M PADILLA MAIZ 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	207T00000X	Neurological Surgery Physician	M8896	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

General Provider Information

NPI Number	:	1770571416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN M PADILLA MAIZ M.D.

Provider Business Mailing Address
First Line	:	2829 BABCOCK RD STE 106
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-6009
Country	:	US
Telephone Number	:	102-951-9055
Fax Number	:	956-630-1078

Provider Business Practice Location Address
First Line	:	2829 BABCOCK RD STE 106
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-6009
Country	:	US
Telephone Number	:	210-951-9055
Fax Number	:	210-951-9066

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

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	09/11/2024

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