Healthcare Provider Details
I. General information
NPI: 1871858985
Provider Name (Legal Business Name): CLARENCE BRETT STEELS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/05/2012
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
520 MADISON OAK DR
SAN ANTONIO TX
78258-3913
US
IV. Provider business mailing address
114 CIRCLE RIDGE DR
BURR RIDGE IL
60527-8379
US
V. Phone/Fax
- Phone: 210-297-4000
- Fax:
- Phone: 808-757-8010
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | MD-17738 |
| License Number State | HI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 036136117 |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 036136117 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | S8497 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: