Healthcare Provider Details

I. General information

NPI: 1932542362
Provider Name (Legal Business Name): CASSANDRA YU GELABERT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2013
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 MCCULLOUGH AVE
SAN ANTONIO TX
78212-5601
US

IV. Provider business mailing address

1310 MCCULLOUGH AVE
SAN ANTONIO TX
78212-5601
US

V. Phone/Fax

Practice location:
  • Phone: 210-757-2257
  • Fax:
Mailing address:
  • Phone: 210-757-2257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberQ5132
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: