Healthcare Provider Details

I. General information

NPI: 1902368681
Provider Name (Legal Business Name): ALEJANDRA CABRERA-SOPO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 MADISON OAK DR STE 240
SAN ANTONIO TX
78258-4086
US

IV. Provider business mailing address

14100 SAN PEDRO AVE STE 200
SAN ANTONIO TX
78232-4362
US

V. Phone/Fax

Practice location:
  • Phone: 210-653-5501
  • Fax:
Mailing address:
  • Phone: 210-653-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberU4473
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: