MEDICARE: DR. LEOPOLDO TECUANHUEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	J4555	TX

General Provider Information

NPI Number	:	1083616197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEOPOLDO TECUANHUEY M.D.

Provider Business Mailing Address
First Line	:	718 CUPPLES RD
Second Line	:	SUITE102
City	:	SAN ANTONIO
State	:	TX
Zip	:	78237-4357
Country	:	US
Telephone Number	:	210-438-0010
Fax Number	:	210-438-0030

Provider Business Practice Location Address
First Line	:	718 CUPPLES ROAD
Second Line	:	SUITE 102
City	:	SAN ANTONIO
State	:	TX
Zip	:	78237-4354
Country	:	US
Telephone Number	:	210-438-0010
Fax Number	:	210-438-0030

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	07/22/2024

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