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NPI 1972580967

NPI 1972580967 : ANATOLE D. TRAKHTENBROIT MD : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1972580967
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    Entity Type          |    Individual 
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    Provider Name        |    ANATOLE D. TRAKHTENBROIT MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/29/2005
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    Last Update Date     |    06/22/2021
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Provider Practice Location Address
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    Address Line         |    8300 FLOYD CURL DR FL 3 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78229-3931
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    Country              |    US
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    Telephone            |    210-450-4888
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    Fax                  |    210-450-6018
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Provider Business Mailing Address
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    Address Line         |    8300 FLOYD CURL DR FL 3 
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78229-3931
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    Country              |    US
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    Telephone            |    210-450-4888
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    Fax                  |    210-450-6018
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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       |    G8992
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    207RC0000X
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    Taxonomy Name        |    Cardiovascular Disease Physician
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    License Number       |    G8992
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    License Number State |    TX
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