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General NPI Number Information
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NPI Number | 1477546075
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Entity Type | Individual
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Provider Name | JOSE FRANCISCO VIDAL MD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2005
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Last Update Date | 07/04/2013
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Provider Practice Location Address
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Address Line | 8026 FLOYD CURL
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3915
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Country | US
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Telephone | 210-575-8229
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Fax | 210-575-8127
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Provider Business Mailing Address
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Address Line | 8109 FREDERICKSBURG RD PHYSICIAN PRACTICE SERVICES
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3311
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Country | US
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Telephone | 210-575-8229
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Fax | 210-575-8127
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | L4158
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | L4158
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License Number State | TX
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