Healthcare Provider Details

I. General information

NPI: 1659325215
Provider Name (Legal Business Name): PABLO MARTIN FEUILLET M D P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 MEDICAL DR STE 330
SAN ANTONIO TX
78229-5805
US

IV. Provider business mailing address

13423 BLANCO RD PMB #210
SAN ANTONIO TX
78216-2187
US

V. Phone/Fax

Practice location:
  • Phone: 210-899-1291
  • Fax: 210-953-5196
Mailing address:
  • Phone: 210-899-1291
  • Fax: 210-953-5196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberK5101
License Number StateTX

VIII. Authorized Official

Name: PABLO M FEUILLET
Title or Position: PRESIDENT
Credential: MD
Phone: 210-899-1291