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General NPI Number Information
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NPI Number | 1255586061
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Entity Type | Organization
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Legal Business Name | RICHARD C. SENELICK, MD, PA
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 9119 CINNAMON HL
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City | SAN ANTONIO
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State | TX
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Zip | 78240-5401
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Country | US
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Telephone | 210-690-1901
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Fax | 210-690-3310
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Provider Business Mailing Address
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Address Line | 9119 CINNAMON HL
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City | SAN ANTONIO
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State | TX
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Zip | 78240-5401
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Country | US
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Telephone | 210-690-1901
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Fax | 210-690-3310
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD C. SENELICK
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Credential | M.D.
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Telephone | 210-690-1901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | E4937
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License Number State | TX
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