Healthcare Provider Details

I. General information

NPI: 1013907831
Provider Name (Legal Business Name): DUANE RUSSELL HOSPENTHAL MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8715 VILLAGE DR STE 514
SAN ANTONIO TX
78217-5407
US

IV. Provider business mailing address

7940 FLOYD CURL DR STE 560
SAN ANTONIO TX
78229-3907
US

V. Phone/Fax

Practice location:
  • Phone: 210-370-9922
  • Fax: 210-545-5616
Mailing address:
  • Phone: 210-614-8100
  • Fax: 210-615-7233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number4301062322
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberP2264
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: