Healthcare Provider Details

I. General information

NPI: 1265631360
Provider Name (Legal Business Name): MY CHARLLINS VILSAINT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7703 FLOYD CURL DR DEPT OF MEDICINE/PULMONARY DISEASES MC 7885
SAN ANTONIO TX
78229-3901
US

IV. Provider business mailing address

7703 FLOYD CURL DR UTHSCSA
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 917-859-0175
  • Fax: 210-949-3006
Mailing address:
  • Phone: 917-859-0175
  • Fax: 210-949-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberQ0381
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: