Healthcare Provider Details

I. General information

NPI: 1528055167
Provider Name (Legal Business Name): CRISTINA CORTEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 10/26/2022
Certification Date: 10/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 W IH 10 STE 200
SAN ANTONIO TX
78201-2041
US

IV. Provider business mailing address

7579 N LOOP 1604 W STE 100
SAN ANTONIO TX
78249-2782
US

V. Phone/Fax

Practice location:
  • Phone: 210-695-1900
  • Fax: 210-695-1901
Mailing address:
  • Phone: 210-695-1900
  • Fax: 210-695-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL7342
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: