MEDICARE: ROBERT LIRA JR MD PA

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	F8932	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	:	1770895294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT LIRA JR MD PA

Provider Business Mailing Address
First Line	:	4006 NOGALITOS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78211-1300
Country	:	US
Telephone Number	:	210-979-6718
Fax Number	:	210-979-7843

Provider Business Practice Location Address
First Line	:	4006 NOGALITOS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78211-1300
Country	:	US
Telephone Number	:	210-979-6718
Fax Number	:	210-979-7843

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT LIRA JR.
Credential	:	MD
Telephone Number	:	210-979-6718

Provider Enumeration Date	:	07/13/2010
Last Update Date	:	07/13/2010

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