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NPI Code Detail

MEDICARE: DR. DANIEL G. PENON M.D.

MEDICARE:  DR. DANIEL G. PENON  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
1207Q00000XFamily Medicine PhysicianL5510TX
2208000000XPediatrics PhysicianL5510TX

Other Identifiers

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

General Provider Information

NPI Number : 1356328132
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANIEL G. PENON M.D.
Provider Business Mailing Address
First Line : 94 BRIGGS ST STE 600
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78224-1272
Country : US
Telephone Number : 210-872-3668
Fax Number : 210-428-6317
Provider Business Practice Location Address
First Line : 94 BRIGGS ST STE 600
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78224-1272
Country : US
Telephone Number : 210-872-3668
Fax Number : 210-922-7818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 06/14/2022

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Directions to “ DR. DANIEL G. PENON M.D.” Practice Location

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