=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871820167
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GERALYN M MENY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2009
-----------------------------------------------------
Last Update Date | 07/03/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4502 MEDICAL DR
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78229-4402
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-358-4000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7703 FLOYD CURL DR MC7977
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78229-3901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-450-9000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | MD037003
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | 42471
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | 00868
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | D0064769
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | 25MA07244400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #6
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | MD071544L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #7
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | J0122
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #8
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | 0101240164
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #9
-----------------------------------------------------
Taxonomy Code | 207ZB0001X
-----------------------------------------------------
Taxonomy Name | Blood Banking & Transfusion Medicine Physician
-----------------------------------------------------
License Number | 23475
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------