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General NPI Number Information
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NPI Number | 1497240295
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Entity Type | Individual
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Provider Name | MICHELINA ROSA IPPOLITI MD
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Gender | Female
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Dates
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Enumeration Date | 06/25/2018
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 2121 SW 36TH ST
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City | SAN ANTONIO
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State | TX
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Zip | 78237-3360
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Country | US
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Telephone | 210-358-5100
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Fax | 210-358-5157
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Provider Business Mailing Address
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Address Line | 2121 SW 36TH ST
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City | SAN ANTONIO
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State | TX
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Zip | 78237-3360
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Country | US
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Telephone | 210-358-5100
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Fax | 201-358-5129
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | S8717
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License Number State | TX
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