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General NPI Number Information
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NPI Number | 1033877089
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Entity Type | Individual
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Provider Name | TINA CHEN FITZGERALD
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Gender | Female
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Dates
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Enumeration Date | 12/07/2021
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Last Update Date | 12/07/2021
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Provider Practice Location Address
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Address Line | 2610 DIAMOND HILL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78232-5631
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Country | US
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Telephone | 408-888-8783
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Fax |
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Provider Business Mailing Address
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Address Line | 2610 DIAMOND HILL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78232-5631
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Country | US
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Telephone | 408-888-8783
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208U00000X
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Taxonomy Name | Clinical Pharmacology Physician
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License Number | 61382
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License Number State | TX
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