Healthcare Provider Details

I. General information

NPI: 1114936408
Provider Name (Legal Business Name): JOY TARA ADEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 SCHERTZ PKWY SUITE 100
SCHERTZ TX
78154-1399
US

IV. Provider business mailing address

1355 CENTRAL PKWY S SUITE 400
SAN ANTONIO TX
78232-5055
US

V. Phone/Fax

Practice location:
  • Phone: 210-650-9978
  • Fax: 210-650-5975
Mailing address:
  • Phone: 210-590-6195
  • Fax: 210-650-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberL8256
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: