Healthcare Provider Details

I. General information

NPI: 1285966937
Provider Name (Legal Business Name): JUAN JOSE TORO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 MERTON MINTER BLVD 111/BMT
SAN ANTONIO TX
78229
US

IV. Provider business mailing address

7400 MERTON MINTER BLVD 111/BMT
SAN ANTONIO TX
78229
US

V. Phone/Fax

Practice location:
  • Phone: 210-617-5300
  • Fax: 210-617-5271
Mailing address:
  • Phone: 210-617-5300
  • Fax: 210-617-5271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: