Healthcare Provider Details

I. General information

NPI: 1275658585
Provider Name (Legal Business Name): DIABETES & ENDOCRINOLOGY CONSULTANTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 10/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E SONTERRA BLVD STE 105
SAN ANTONIO TX
78258-3988
US

IV. Provider business mailing address

155 E SONTERRA BLVD STE 105
SAN ANTONIO TX
78258-3988
US

V. Phone/Fax

Practice location:
  • Phone: 210-314-8045
  • Fax: 210-314-8073
Mailing address:
  • Phone: 210-314-8045
  • Fax: 210-314-8073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAIME OSCAR CRUZ
Title or Position: OFFICER
Credential: M.D.
Phone: 210-314-8045