Healthcare Provider Details

I. General information

NPI: 1902155807
Provider Name (Legal Business Name): ROBERT CHING DO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7115 FAIRLAWN DR
SAN ANTONIO TX
78223-4022
US

IV. Provider business mailing address

7115 FAIRLAWN DR
SAN ANTONIO TX
78223-4022
US

V. Phone/Fax

Practice location:
  • Phone: 210-337-2600
  • Fax: 210-337-2644
Mailing address:
  • Phone: 210-337-2600
  • Fax: 210-337-2644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA06889
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ9642
License Number StateTX

VIII. Authorized Official

Name: DR. ROBERT T CHING
Title or Position: OWNER
Credential: D.O.
Phone: 210-337-2600