Healthcare Provider Details

I. General information

NPI: 1417691452
Provider Name (Legal Business Name): MARCUS JOHN QUINT JR. D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 S GENERAL MCMULLEN DR
SAN ANTONIO TX
78226-1190
US

IV. Provider business mailing address

1831 S GENERAL MCMULLEN DR
SAN ANTONIO TX
78226-1190
US

V. Phone/Fax

Practice location:
  • Phone: 210-644-8520
  • Fax: 210-644-8525
Mailing address:
  • Phone: 210-644-8500
  • Fax: 210-644-8507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW0984
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: