Healthcare Provider Details

I. General information

NPI: 1639450182
Provider Name (Legal Business Name): JEREMIAS M. ABUEME,MD,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 08/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5282 MEDICAL DR STE 130
SAN ANTONIO TX
78229-6023
US

IV. Provider business mailing address

5282 MEDICAL DR STE 130
SAN ANTONIO TX
78229-6023
US

V. Phone/Fax

Practice location:
  • Phone: 210-615-8434
  • Fax: 210-615-8436
Mailing address:
  • Phone: 210-615-8434
  • Fax: 210-615-8436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License NumberJ7401
License Number StateTX

VIII. Authorized Official

Name: MRS. LILIA P ABUEME
Title or Position: MANAGER
Credential:
Phone: 210-615-8434