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General NPI Number Information
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NPI Number | 1093009276
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Entity Type | Individual
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Provider Name | EMILIO FENTANES M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/05/2011
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-539-8414
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932163
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City | CLEVELAND
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State | OH
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Zip | 44193-0008
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Country | US
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Telephone | 610-477-6147
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Fax | 302-440-5532
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD17066
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 315357
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License Number State | NY
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