Healthcare Provider Details

I. General information

NPI: 1619927571
Provider Name (Legal Business Name): REINALDO ACOSTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 N SAN SABA STE 930
SAN ANTONIO TX
78207-3154
US

IV. Provider business mailing address

315 N SAN SABA STE 1135
SAN ANTONIO TX
78207-3255
US

V. Phone/Fax

Practice location:
  • Phone: 210-704-3200
  • Fax: 210-704-2718
Mailing address:
  • Phone: 210-704-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberT1889
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: