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General NPI Number Information
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NPI Number | 1891090221
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Entity Type | Organization
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Legal Business Name | MARK A. ISAEFF, MD PA
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Dates
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Enumeration Date | 01/16/2011
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Last Update Date | 04/14/2011
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Provider Practice Location Address
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Address Line | 1303 MCCULLOUGH AVE 542
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City | SAN ANTONIO
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State | TX
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Zip | 78212-5609
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Country | US
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Telephone | 210-572-4431
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Fax | 210-572-4435
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Provider Business Mailing Address
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Address Line | 1303 MCCULLOUGH AVE 542
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City | SAN ANTONIO
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State | TX
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Zip | 78212-5609
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Country | US
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Telephone | 210-572-4431
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Fax | 210-572-4435
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK A ISAEFF
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Credential | MD
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Telephone | 210-572-4431
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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 |
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License Number State |
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