MEDICARE: DR. EDUARDO LM AQUINO M.D., P.A.

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	174400000X	Specialist	E9513	TX

General Provider Information

NPI Number	:	1083768808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDUARDO LM AQUINO M.D., P.A.

Provider Business Mailing Address
First Line	:	21 INWOOD HEIGHTS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78248-2314
Country	:	US
Telephone Number	:	210-614-4742
Fax Number	:	210-614-2633

Provider Business Practice Location Address
First Line	:	8600 WURZBACH RD STE 900E
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4333
Country	:	US
Telephone Number	:	210-614-4742
Fax Number	:	210-614-2633

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/08/2007

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