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General NPI Number Information
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NPI Number | 1043678048
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Entity Type | Organization
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Legal Business Name | TITANIUM GENERAL INTERNAL MEDICINE MEDICAL SERVICES PA
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 200 MEMORIAL DR
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City | LULING
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State | TX
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Zip | 78648-3213
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Provider Business Mailing Address
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Address Line | PO BOX 1662
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City | SEGUIN
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State | TX
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Zip | 78156-8662
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Authorized Official
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Title or Position | SOLE OWNER
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Name | JUAN E ARENAS-HERRERA
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Credential | MD
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Telephone | 830-312-1116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | Q2507
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License Number State | TX
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