MEDICARE: LOUIS P MCDONALD

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	247200000X	Other Technician

General Provider Information

NPI Number	:	1538432273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS P MCDONALD

Provider Business Mailing Address
First Line	:	1116 E HOUSTON ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-2031
Country	:	US
Telephone Number	:	210-226-1482
Fax Number	:	210-299-1670

Provider Business Practice Location Address
First Line	:	1116 E HOUSTON ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-2031
Country	:	US
Telephone Number	:	210-226-1482
Fax Number	:	210-299-1670

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

Provider Enumeration Date	:	02/10/2012
Last Update Date	:	02/10/2012

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Directions to “ LOUIS P MCDONALD ” Practice Location

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