MEDICARE: DR. ANDREW A TOBON 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	208800000X	Urology Physician	J3384	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174503106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW A TOBON MD

Provider Business Mailing Address
First Line	:	7909 FREDERICKSBURG RD
Second Line	:	SUITE#110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3425
Country	:	US
Telephone Number	:	210-614-4544
Fax Number	:	210-679-3724

Provider Business Practice Location Address
First Line	:	3327 RESEARCH PLZ
Second Line	:	SUITE # 403
City	:	SAN ANTONIO
State	:	TX
Zip	:	78235-5155
Country	:	US
Telephone Number	:	210-474-7020
Fax Number	:	210-679-3734

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

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	11/09/2011

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