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General NPI Number Information
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NPI Number | 1902425994
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Entity Type | Individual
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Provider Name | PAVELA G. BAMBEKOVA MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 7979 WURZBACH RD BLDG 3
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4427
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Country | US
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Telephone | 210-450-9840
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Fax | 210-450-6064
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Provider Business Mailing Address
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Address Line | 7979 WURZBACH RD BLDG 3
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City | SAN ANTONIO
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State | TX
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Zip | 78229-4427
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Country | US
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Telephone | 210-450-9840
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Fax | 210-450-6064
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | U9836
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License Number State | TX
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