=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497750681
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAIME FURMAN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2005
-----------------------------------------------------
Last Update Date | 12/06/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7909 FREDERICKSBURG RD STE 150
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78229-3400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-521-7700
-----------------------------------------------------
Fax | 210-521-7710
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9600 DATAPOINT DR STE 150
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78229-2028
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-521-7700
-----------------------------------------------------
Fax | 210-521-7710
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207ZP0101X
-----------------------------------------------------
Taxonomy Name | Anatomic Pathology Physician
-----------------------------------------------------
License Number | L2263
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------