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1104877935

NPI Code Detail

MEDICARE: DR. TIMOTHY S FENSKE MD

MEDICARE: DR. TIMOTHY S FENSKE MD

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	207RH0003X	Hematology & Oncology Physician	V6299	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	039906261S	OTHER		HUMANA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104877935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY S FENSKE MD

Provider Business Mailing Address
First Line	:	4450 MEDICAL DR FL 1
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3710
Country	:	US
Telephone Number	:	210-575-3817
Fax Number	:	210-575-4113

Provider Business Practice Location Address
First Line	:	4450 MEDICAL DR FL 1
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3710
Country	:	US
Telephone Number	:	210-575-3817
Fax Number	:	210-575-4113

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	02/21/2025

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Directions to “ DR. TIMOTHY S FENSKE MD” Practice Location

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