Healthcare Provider Details

I. General information

NPI: 1508946872
Provider Name (Legal Business Name): ILDIKO AGOSTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 FLOYD CURL DR 3RD FL - 3B
SAN ANTONIO TX
78229-3931
US

IV. Provider business mailing address

903 W MARTIN ST # MS 49-2
SAN ANTONIO TX
78207-0903
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-4888
  • Fax: 210-450-6018
Mailing address:
  • Phone: 201-358-5909
  • Fax: 210-358-5940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberL2779
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: