MEDICARE: DR. JAIME OSCAR CRUZ 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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	H5394	TX

General Provider Information

NPI Number	:	1396746442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAIME OSCAR CRUZ M.D.

Provider Business Mailing Address
First Line	:	155 E SONTERRA BLVD STE 105
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3988
Country	:	US
Telephone Number	:	210-314-8045
Fax Number	:	210-314-8073

Provider Business Practice Location Address
First Line	:	155 E SONTERRA BLVD STE 105
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3988
Country	:	US
Telephone Number	:	210-314-8045
Fax Number	:	210-314-8073

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	01/12/2014

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