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General NPI Number Information
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NPI Number | 1083645964
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Entity Type | Individual
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Provider Name | ROLAND F MENA PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 09/04/2015
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Provider Practice Location Address
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Address Line | 1805 CASTROVILLE RD
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City | SAN ANTONIO
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State | TX
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Zip | 78237-3659
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Country | US
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Telephone | 210-433-6909
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Fax | 210-433-6907
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Provider Business Mailing Address
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Address Line | 426 CASTROVILLE RD, STE #4
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City | SAN ANTONIO
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State | TX
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Zip | 78207
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Country | US
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Telephone | 210-994-6181
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Fax | 210-973-5819
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00125
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License Number State | TX
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