Healthcare Provider Details

I. General information

NPI: 1811981350
Provider Name (Legal Business Name): JOHN C ANES M D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 05/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 MCCULLOUGH AVE SUITE 560
SAN ANTONIO TX
78212-5609
US

IV. Provider business mailing address

8109 FREDERICKSBURG RD PHYSICIAN PRACTICE SERVICES
SAN ANTONIO TX
78229-3311
US

V. Phone/Fax

Practice location:
  • Phone: 210-223-9617
  • Fax: 210-472-2669
Mailing address:
  • Phone: 210-223-9617
  • Fax: 210-472-2669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberF2154
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: